The Effect of Foreign Surfaces on Blood Coagulation 12

Abstract

In the United States, the two-stage theory of blood coagulation is widely accepted. This theory recently reviewed by Quick (1) and Eagle (2) suggests that in the first stage prothrombin, calcium ion and thromboplastin interact to form thrombin. Thrombin, in the second stage, converts fibrinogen to fibrin. Plasma thromboplastin has been considered to be of platelet origin. The phenomenon of the initiation of coagulation when blood is shed has been considered by many investigators to be due to the disintegration of platelets with the release of thromboplastin.It has been known for many years that the coagulation time of blood taken in paraffin tubes is much longer than that of blood taken in glass tubes. The explanation usually offered for this phenomenon is that the glass, acting as a foreign surface, destroys the platelets at a more rapid rate than occurs in the presence of paraffin. The increased amount of thromboplastin so liberated is then considered to be responsible for the shorter coagulation time in glass vessels. Nolf (3) has criticized this explanation. He states that his experimental data indicate that cell-and platelet-free plasma already contains all of the factors necessary for blood coagulation. He believes that the initiation of coagulation is the result of the direct modification of one or more of the constituents of cellfree plasma by contact with a foreign surface such as glass.In view of this difference of opinion, it seemed advisable to reinvestigate the role which foreign surfaces play in the blood coagulation reaction.

Surface as a Quantitative Factor in Prothrombin Utilization1

“…The current experiments again demonstrate that celland "platelet-free" plasma does clot, and furthermore, demonstrate that the rate of prothrombin utilization during clotting of such plasma is a function of the degree of exposure to glass surface. The earlier work has been criticized because the test plasma was not shown to be platelet-free since platelet counts were not performed (1, 3, 5-7), or the methods of counting platelets made it impossible to evaluate the actual platelet levels (8). In more recent work (14), and in the current experiments, direct observation of undiluted plasma samples using the phase contrast microscope have eliminated these objections.…”

“…." Since the original observations of Lister, many subsequent investigators have studied this phenomenon (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15).…”

Preservation of Normal Human Plasma in the Liquid State. Ii. Comparative in Vitro Studies on the Physiologic Activity of Labile Constituents of Liquid and Frozen Plasma 12

“…of the plasma to be tested had been added. Coagulation times were performed by a modified (8) Lee and White method (9).…”

Boston city hospital and the thorndike memorial laboratory: the birth of modern haematology

“…Pohle and Taylor (1937) first demonstrated that intramuscular use of this globulin substance was effective in correcting the clotting time in patients with haemophilia, but also demonstrated the refractory state induced by subsequent injections. The Thorndike also participated in the beginnings of the modern understanding of disseminated intravascular coagulation when Lozner and Taylor (1942) reported the effects of artificial surfaces on the initiation of coagulation and Tagnon et al (1942) studied the fibrinolytic activity of plasma. Lymphoma Henry Jackson Jr was the major contributor to morphological research in haematology at the Thorndike.…”