Alternative pathways in blood coagulation

Two thrombin independent reactions involving polymerization and gelation of fibrinogen (FBG) and of FBG and fibronectin (FN) are described. In the first reaction FXIII, in the presence of calcium ions, induces oligomerization and eventually complete gelation of FBG, i.e. formation of fibrinogenin. FBG dimers and probably also higher oligomers are formed by the crosslinking of gamma-chains prior to gelation. During gelation the A alpha-chains also become completely crosslinked. These reactions are enhanced by a variety of thiol compounds. With DTT, reduction of specific disulfides in the A alpha-chain of FBG appear to be responsible for the enhancement. In the second reaction, FXII catalyzes the formation of heteropolymers of FBG-FN. These complexes eventually form visible particulate matter called heteronectin. Dimers consisting of 1 mole FBG and 1 mole FN form first, followed by the appearance of higher order heteronectin intermediates. In heteronectin the A alpha-chain of FBG provides the linkage to FN. Thiols also enhance the heteronectin reaction. Formation of fibrinogen and/or heteronectin depends upon the initial relative concentrations of FBG and FN. At equimolar concentrations mainly heteronectin is formed. During clotting of normal whole blood, thrombin induced fibrin formation is the initial event followed by rapid fibrinogen formation. Addition of iodoacetamide (an inhibitor of FXIII) to whole blood prevents the formation of fibrinogenin. These findings suggest that the fibrinogen pathway is important in vivo.