Insoluble Fibrin

The future is in the hands of those who will have been able to give tomorrow’s generation valid reasons to live and hope.”

——Teilhard de Chardin

Insoluble fibrin is the “universal polymer of hemostasis.” Factor VIII adds plasminogen and fibronectin cross-links to fibrillar soluble fibrin to generate three dimensional insoluble fibrin monomers that spontaneously polymerizes into strands that bind red cells and platelets together. This binding increases blood viscosity and coagulability, accelerates atherosclerosis, activates capillary hemostasis, and forms viscoelastic clots. The plasminogen cross-links spontaneously deteriorate into plasmin that disintegrates insoluble fibrin into inert fibrin split products (FSP, or d-Dimer) — unless plasminogen is continuously stabilized by thrombin via "thrombin activated fibrinolysis inhibitor" (TAFI).

Insoluble fibrin cannot escape the intact vascular system. Its generation and disintegration explains coagulation, capillary hemostasis, the capillary gate mechanism, hemodynamic physiology, organ regulation, infarction, and the effects of anticoagulants and “vasoactive” drugs.

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