What is Prothrombin
The blood has a clotting functionality during the coagulation process but in fact can’t do so without prothrombin which is a blood protein vital in blood clotting. This essential blood protein is also referred as Factor II.
Prothrombin/Factor II has a role in the formation of fibrin which combines with the platelets in order for the system to initiate the entire clotting process. This makes it simple to say that without prothrombin, there will be no fibrin and without fibrin, there is a bleeding propensity.
1. PRODUCTION OF PROTHROMBIN
The liver has the major role in the existence of prothrombin. In fact, blood proteins such as prothrombin are produced by the organ. After prothrombin is produced, it is altered in a vitamin.
There are a number of acids known as glutamic acids present in prothrombin. These acids are transformed to GLA or gamma carboxyglutamic acid by vitamin K.
2. FORMATION OF THROMBIN
In the coagulation cascade, coagulation factor II is slashed for the formation of thrombin. Therefore, thrombin is shown to come from prothrombin as the name itself suggests.
Thrombin eventually helps in reducing the amount of blood loss. It also changes fibrinogen to fibrin since it is known to act as a catalyst and as a serine protease.
Thrombin also enhances the activation of protein C which is the coagulation cascade inhibitor.
3. BLOOD CLOTTING
A normal body should not display excessive bleeding or even blood clots in blood vessels. Therefore, there must have a balance in the body otherwise, bleeding or blood clot formation may result if at all the balancing fails.
During blood clotting, the platelets and proteins in the blood work together to restore the injury and minimize the amount of blood being wasted. These two are being generated and activated naturally in the body when injury occurs. They (cells/platelets and clotting proteins) normally respond to block the vessel interference.
4. THE FACTOR II TIME
The prothrombin time or the factor II time measures the duration in which fibrin formation should occur when thromboplastin tissue is added. When the blood does not clot normally, the prothrombin time indicates that there is absence of a coagulant or a blood clotting factor.
Prothrombin time is mostly undertaken to observe patients under medications and also used to diagnose clotting disorders.
Conditions that may affect blood clotting:
- Deficiency in clotting factors
- Bone marrow disorders
- Immune system response
- Shortage/lack of Vitamin K
- Liver diseases and many others
The factor II time helps to diagnose these disorders. The prothrombin time is primarily important to determine whether the patient’s blood is clotting properly or not.
5. CLOTTING FACTORS
Thromboplastin is one of the clotting factors. The clotting factors change the blood from liquid state to solid state. The clotting factors are shown to be produced by the liver.
Since thrombin reduces/stops blood clot, it is being produced faster by prothrombin when an injury is experienced. During this state of injury, prothrombin must change normally although in some instances, the body might be experiencing an underlying disorder that influences the blood clotting process.
6. FACTOR II MUTATION
Factor II mutation which is also known as the prothrombin 20210 mutation require tests due to possible complications. People are said to be having a prothrombin mutation when their bodies produce excess prothrombin protein whereby in this condition, the blood is likely to clot. A test for factor II mutation is carried on when:
- Pulmonary embolism is suspected
- Miscarriage is experienced
- There is a deep vein thrombosis
- Blood clot has been spotted in a rare location, etc.
- Sam Safavi-Abbasi, M.D., Ph.D., Federico Di Rocco, M.D., Peter Nakaji, M.D., Guenther C. Feigl, M.D., Alireza Gharabaghi, M.D., Madjid Samii, M.D., Ph.D., Anton Valavanis, M.D., Ph.D., & Amir Samii, M.D., Ph.D. (2008). Thrombophilia Due to Factor V and Factor II Mutations and Formation of a Dural Arteriovenous Fistula: Case Report and Review of a Rare Entity.
7. PROTHROMBIN MUTATION DIAGNOSIS
Prothrombin mutation can be analyzed through blood tests. The patient’s blood sample will be taken and placed in a tube with sodium citrate which ensures that there is no blood clot before the test is complete.
During the test, the patient’s protein in blood is added to the plasma. Since there is sodium citrate in the mixture, the blood cannot clot even if it reaches the required temperatures. Calcium chloride is supplemented for blood clotting to occur.
8. OCCURRENCE OF FACTOR II MUTATION
During the test, the DNA is tested for it is needed to determine the heterozygous and homozygous conditions. When the result shows homozygous prothrombin which has two prothrombine genes, there is a high chance of getting deep vein thrombosis. If at all you are heterozygous, it means that you have mutation in one of your prothrombin genes.
9. IMPLICATIONS OF FACTOR II MUTATION
A blood clot can be dislodged and travel to the deep veins, and may also dangerously reach the lungs. This blood clot is known as deep vein thrombosis (DVT) which can be much intimidating for it can be very harmful, causing:
- Swelling of the legs
- Blood vessel impairment especially of the lungs
- Pain in some parts of the body
- Coughing sometimes with blood
Prothrombin is normally essential during the blood clotting process but a high rate of risk comes with factor II mutation.
10. HEREDITARY RISK FACTORS
It is recommended for patients who have or ever had experienced deep vein thrombosis to be tested for prothrombin mutation. Prothrombin mutation as a hereditary risk factor may be seen in various people especially in:
- Individuals who had been experiencing blood clot at a young age
- Individuals experiencing pregnancy problems relevant to blood clots
- Individuals with blood clots in areas like the lungs and brain
Surgery in patients with prothrombin mutation has a high blood clot rate. It is recommended that when the patient needs undertaking surgery or hospitalization, the doctor in charge should be concerned in determining the patients’ history concerning prothrombin mutation.
Prothrombin mutation occurs mostly in people who have had pregnancy complication. Mothers who have the prothrombin mutation most likely give birth to babies of less weight, or small babies.
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