Natural proteinase inhibitors: blood coagulation inhibition and evolutionary relationships

1. Natural proteinase inhibitors are divided into polysaccharides, plasma proteinase inhibitors and natural non-plasma inhibitors. 2. Polysaccharides are antithrombin-III and heparin co-factor-II dependent or independent regarding their biological activity. Knowledge of the inhibitory mechanism at a molecular level was gained by the study of heparin. 3. Antithrombin-III, heparin-co-factor-II and alpha 2-macroglobulin are the most important plasma proteinase inhibitors involved in coagulation. alpha 2-macroglobulin has a particular inhibitory mechanism. 4. Non-plasma proteinase inhibitors were isolated from many species. They inhibit mainly the contact activation and fibrinolysis. 5. The evolutionary relationships are poorly understood.