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Updated: Aug 17, 2026

Leveraging Turbidity and Thromboelastography for Complementary Clot Characterization
Published on: June 4, 2020
Evidence that meizothrombin is an intermediate product in the clotting of whole blood
E G Bovill1, R P Tracy, T E Hayes
1Department of Pathology, University of Vermont College of Medicine, Burlington 05405, USA.
Abstract:
Meizothrombin is an intermediate that is produced during the conversion of prothrombin to thrombin in systems composed of purified factor Xa and factor Va that are quantitatively assembled on an anionic phospholipid surface. The biological significance of this intermediate has recently been challenged by the apparent absence of meizothrombin during clotting of sodium citrate-anticoagulated plasma. We analyzed the formation of thrombin during coagulation of nonanticoagulated, unchilled, minimally manipulated whole blood in glass tubes. The process was stopped at 0, 3, 5, and 7 minutes by the addition of biotinylated peptidyl chloromethyl-ketone active-site labeling reagents. Plasma/serum was separated by centrifugation, and labeled species were extracted by immunoadsorption with a polyclonal anti-prothrombin antibody. The purified prothrombin-derived species were separated by SDS-polyacrylamide gradient gel electrophoresis and visualized on a chemiluminescent avidin blot. Meizothrombin appeared as an intermediate product of this reaction and persisted with some increase through the 7-minute time point. We also observed incorporation of the active-site label into a species of lower molecular weight consistent with the B1 chain of beta- and/or gamma-thrombin. These degraded forms of thrombin have not been previously demonstrated in a biologically relevant preparation. Our data clearly establish the generation of meizothrombin as an intermediate product of thrombin generation during whole-blood clotting. The data also represent the first experimental evidence for the generation of beta- and gamma-thrombin in a biologically relevant environment and time scale.
Insights
Meizothrombin is a key intermediate in thrombin generation during whole blood clotting. This study confirms its presence and also reveals the formation of beta- and gamma-thrombin in a biologically relevant setting.
Area of Science:
- Biochemistry
- Hematology
- Molecular Biology
Background:
- Meizothrombin is an intermediate in prothrombin to thrombin conversion.
- Its biological significance was questioned due to its apparent absence in plasma.
- Previous studies used purified components or anticoagulated plasma.
Purpose of the Study:
- To investigate meizothrombin formation during whole blood coagulation.
- To determine the presence of meizothrombin in a biologically relevant environment.
- To identify other thrombin species generated during clotting.
Main Methods:
- Coagulation of nonanticoagulated whole blood was analyzed.
- Active-site labeling reagents were used to stop the reaction at specific time points.
- Immunoadsorption, SDS-PAGE, and chemiluminescent blotting were employed for analysis.
Main Results:
- Meizothrombin was identified as an intermediate product during whole blood clotting.
- Meizothrombin levels increased over a 7-minute time course.
- Degraded forms of thrombin, beta- and gamma-thrombin, were detected for the first time in this context.
Conclusions:
- Meizothrombin generation is confirmed during whole blood clotting.
- The study provides the first evidence for beta- and gamma-thrombin generation in a biologically relevant environment.
- These findings clarify the role of meizothrombin and identify novel thrombin species in hemostasis.
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