2026-06-27T22:25:34Zhttps://docta.ucm.es/rest/oai/request

oai:docta.ucm.es:20.500.14352/951262025-03-18T12:53:20Zcom_20.500.14352_14col_20.500.14352_15

Serrano, Luis Javier Sánchez, María José De Pablo Moreno, Juan Andrés Revuelta Rueda, Luis Liras Martín, Antonio 2024-01-24T13:30:47Z 2024-01-24T13:30:47Z 2022-07-27 1422-0067 10.3390/ijms23158283 https://hdl.handle.net/20.500.14352/95126 https://www.mdpi.com/1422-0067/23/15/8283 The vascular endothelium has several important functions, including hemostasis. The homeostasis of hemostasis is based on a fine balance between procoagulant and anticoagulant pro-teins and between fibrinolytic and antifibrinolytic ones. Coagulopathies are characterized by a mutation-induced alteration of the function of certain coagulation factors or by a disturbed balance between the mechanisms responsible for regulating coagulation. Homeostatic therapies consist in replacement and nonreplacement treatments or in the administration of antifibrinolytic agents. Rebalancing products reestablish hemostasis by inhibiting natural anticoagulant pathways. These agents include monoclonal antibodies, such as concizumab and marstacimab, which target the tissue factor pathway inhibitor; interfering RNA therapies, such as fitusiran, which targets antithrombin III; and protease inhibitors, such as serpinPC, which targets active protein C. In cases of throm- bophilia (deficiency of protein C, protein S, or factor V Leiden), treatment may consist in direct oral anticoagulants, replacement therapy (plasma or recombinant ADAMTS13) in cases of a congenital deficiency of ADAMTS13, or immunomodulators (prednisone) if the thrombophilia is autoimmune. Monoclonal-antibody-based anti-vWF immunotherapy (caplacizumab) is used in the context of severe thrombophilia, regardless of the cause of the disorder. In cases of disseminated intravascular coagulation, the treatment of choice consists in administration of antifibrinolytics, all-trans-retinoic acid, and recombinant soluble human thrombomodulin. eng http://creativecommons.org/licenses/by/4.0/ open access Attribution 4.0 International The vascular endothelium and coagulation: homeostasis, disease, and treatment, with a focus on the von willebrand factor and factors VIII and V journal article