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 Thrombin-cofactor interactions: structural insights into regulatory mechanisms Adams TE; Huntington JAArterioscler Thromb Vasc Biol  2006[Aug]; 26 (8): 1738-45Precise modulation of thrombin activity throughout the hemostatic response is  essential for efficient cessation of bleeding while preventing inappropriate clot  growth or dissemination which causes thrombosis. Regulating thrombin activity is  made difficult by its ability to diffuse from the surface on which it was  generated and its ability to cleave at least 12 substrates. To overcome this  challenge, thrombin recognition of substrates is largely controlled by cofactors  that act by localizing thrombin to various surfaces, blocking substrate binding  to critical exosites, engendering new exosites for substrate recognition and by  allosterically modulating the properties of the active site of thrombin. Thrombin  cofactors can be classified as either pro- or anticoagulants, depending on how  substrate preference is altered. The procoagulant cofactors include glycoprotein  Ibalpha, fibrin, and Na+, and the anticoagulants are heparin and thrombomodulin.  Over the last few years, crystal structures have been reported for all of the  thrombin-cofactor complexes. The purpose of this article is to summarize the  features of these structures and to discuss the mechanisms and physiological  relevance of cofactor binding in thrombin regulation.|Binding, Competitive[MESH]|Blood Coagulation Factors/*physiology[MESH]|Fibrin/physiology[MESH]|Glycosaminoglycans/metabolism[MESH]|Heparin/metabolism[MESH]|Humans[MESH]|Kinetics[MESH]|Platelet Glycoprotein GPIb-IX Complex/metabolism[MESH]|Sodium/metabolism[MESH]|Thrombin/chemistry/metabolism/*physiology[MESH]|Thrombomodulin/metabolism[MESH]
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