D-dimer physiology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Physiology

Fibrin degradation products (FDPs) are formed whenever fibrin is broken down by enzymes. In fact, FDP are formed as a result of the sequential actions of the following three different enzymes: thrombin, factor VIII and plasmin. Determining FDPs is not considered useful, as this does not indicate whether the fibrin is part of a blood clot (or being generated as part of inflammation).

D-dimers are unique in that they are the breakdown products of a fibrin mesh that has been stabilized by Factor XIII. This factor crosslinks the E-element to two D-elements. This is the final step in the generation of a thrombus.

Plasmin is a fibrinolytic enzyme that organizes clots and breaks down the fibrin mesh. It cannot, however, break down the bonds between one E and two D units. The protein fragment thus left over is a D-dimer.[1]

Shown below is an image summarizing the formation of D-dimers and other fibrin degradation products as a result of the sequential action of the three enzymes: thrombin, factor VIII and plasmin.


Formation of D-dimer
Formation of D-dimer


References

  1. Adam SS, Key NS, Greenberg CS (2009). "D-dimer antigen: current concepts and future prospects". Blood. 113 (13): 2878–87. doi:10.1182/blood-2008-06-165845. PMID 19008457‎ Check |pmid= value (help).

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