Relative proteolysis of the fibrinogen Bβ chain by thrombin and plasmin as a determinant of thrombosis

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Abstract
Thrombosis partially results from localized accumulation of fibrin, implying an imbalance between its rate of formation and dissolution. Astrup postulated that patency of the vascular system depended on a dynamic equilibrium between constantly active coagulation and fibrinolytic systems. Reviews of this hypothesis concluded that neither thrombin nor plasmin proteolysis makes a major contribution to fibrinogen turnover in normal individuals and that the hypothesis of a dynamic equilibrium between clotting and lysis remains unproven. Thus, the current view is that plasmin instead serves the function of fibrinolytic enzyme digesting fibrin in the vascular system. The alternative view that the relative rates of proteolysis of the B.beta. chain of fibrinogen by thrombin and plasmin determine the occurence of thrombosis is promoted here. This view is supported by data and can be used to make testable predictions.