Prokoagulant

A prokoagulant is a substance that promotes the coagulation of blood. It functions by accelerating steps in the clotting cascade, increasing the conversion of fibrinogen to fibrin or stimulating platelet aggregation. Prokoagulants can be endogenous, such as tissue factor released from damaged cells, or exogenous, derived from pharmaceuticals or toxins.

In medicine, prokoagulants are used therapeutically to control bleeding during surgery or in trauma. Recombinant activated factor VII and prothrombin complex concentrates are common agents that enhance clot formation. They are chosen when rapid haemostasis is required and when anticoagulants are contraindicated. However, excessive prokoagulant activity can predispose to thrombosis, causing conditions like deep vein thrombosis or pulmonary embolism. Thus, dosing is carefully monitored in clinical settings.

The study of prokoagulant pathways is also important for understanding haemostatic disorders. Patients with deficiencies in natural inhibitors, such as antithrombin or protein C, display a prokoagulant tendency leading to thrombotic diseases. Research into inhibitors of prokoagulants, and their balance with anticoagulants, helps develop treatments for both bleeding disorders and thrombotic risk reduction.