Thrombin-thrombomodulin

A type I transmembrane protein called endothelial cell protein C receptor (EPCR), which is expressed at high levels exclusively on a subset of endothelial cells, has also been identified. EPCR has a role in the protein C pathway (30). EPCR binds to both protein C and activated protein C (APC) with equal affinity. Activation of protein C presumably requires interaction of the protein C-EPCR complex with the thrombin-thrombomodulin complex. APC that is formed as a result of this interaction is reversibly bound to EPCR until it dissociates to react subsequently with protein S. The APC-protein S complex inactivates activated factor V (Va). 

Although the fibrinolytic pathway is activated when thrombin binds to thrombomodulin, the thrombin-thrombomodulin complex, in addition to activating protein C (APC), activates a fibrinolysis inhibitor called the thrombin-activatable fibrinolysis inhibitor (TAFIa). Thus plasmin generation and, in turn, fibrinolysis are... 

Nesheim M., Wang W., Bofta M., et al. Thrombin, thrombomodulin and TAFI in the molecular link between coagulation and fibrinolysis. Thromb Haemost 1997 78,386-91. 

Fuentes-Prior P, et al. Structural basis for the anticoagulant activity of the thrombin-thrombomodulin complex. Nature 2000 404 518-525. 

P. Fuentes-Prior, Y. Iwanaga, R. Huber, R. Pagila, G. Rumennik, M. Seto, J. Morser, D.R. Light, and W. Bode. 2000. Structural basis for the anticoagulant activity of the thrombin-thrombomodulin complex Nature. 404 518-525. 

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