By Deb Burrows, BS, MA
A short video opened the session A Journey Through the Clotting Cascade on Friday morning. The video, along with hands-on training, provided an overview of the three pathways involved in the clotting cascade: the common pathway, the intrinsic pathway, and the extrinsic pathway. Heather Hicks, MPH, manager of education for the National Bleeding Disorders Foundation, led the presentation.
Major players in blood coagulation include the red blood cell, the platelet and an activated platelet. Platelets move toward an injury, spread out and stick together at the site of the injury. “This is not enough to stop bleeding,” Hicks said. “We need the rest of the clotting cascade to form a blood clot.”
Factor III or tissue factor is activated when there is a break in the skin. It joins with factor VII, and together they activate factor X.
These comprise the extrinsic pathway, Hicks said. “If you are missing one of these factors, you may still get some clotting from the intrinsic pathway.
The intrinsic pathway begins with the bonding of factor XIa and factor IX. Individuals with hemophilia B are lacking in factor IX,” she said.
Hicks continued by saying that factor VIII and factor IX team together to activate factor X. “Activating factor X starts the common pathway. The common pathway can be activated through the extrinsic or intrinsic pathway,” she said. “Once the fibrin clot is made, factor XIII makes sure it is strong and doesn’t fall apart. Von Willebrand factor (VWF) stabilizes factor VIII and allows for activation of factor X. Factor Xa and factor V interact and transform into prothrombin. When they activate, they become thrombin and activate fibrinogen to change it into fibrin. Factor XIII strengthens this formation and allows crosslinking to form a clot.”
All of these factors must activate correctly to form clots. Hicks mentioned treatments available for those who may be missing a factor in their clotting cascade:
· Factor replacement therapy replaces a missing factor and allows all the pieces of the pathways to work.
· Bispecific antibody therapy forms a bridge between FIX and FX without needing FXIII.
· Anti-TFPI (still in clinical trials) helps the pathway to continue when a factor is missing.
The Final Night Event of the 2023 Bleeding Disorders Conference will represent a fresh start for our community. Let’s celebrate our organization’s new name - National Bleeding Disorders Foundation - representing our new mission for the future.
BDC Final Night Event – 75th Anniversary edition will be a special tribute to the foundation’s history, leaders and milestones which are the roots of our organization, and the legacy of hope, resilience and commitment that we carry forward as our blood and bleeding disorders community blooms in numbers, diversity, and strength.
A banquet of hors d'oeuvres and snacks will be served, showcasing Maryland's famous American classics and local land and sea delights. Wear pink to celebrate!
Saturday, 5:30 p.m. - 7:30 p.m.
Everyone
Atrium | Lower Atrium Level
