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The cap acts as a protective barrier between circulating blood and the thrombogenic, procoagulant contents of the lesion.
Thrombomodulin is an integral membrane glycoprotein that binds thrombin changing it from a procoagulant protein to an anticoagulant.
When nitric oxide is deficient or used inadequately, endothelium becomes a procoagulant instead of an anticoagulant, and vasoactive molecules, cytokines, and growth factors are formed.
In hemostasis, there is a balance between procoagulant factors and natural anticoagulant proteins.
Protective mechanisms prevent thrombin and other procoagulant enzymes from forming in healthy intact blood vessels.
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