The role of the red cell membrane in thrombin generation

Thromb Res. 2013 May;131(5):377-82. doi: 10.1016/j.thromres.2013.01.023. Epub 2013 Feb 10.


Red blood cells have historically been viewed as innocent bystanders in the process of blood coagulation and thrombin generation; however a century of clinical evidence linking red blood cells to thrombosis suggests the contrary. In this brief review, the biochemical evidence for red blood cell involvement in thrombin generation is evaluated. It is concluded that in addition to platelets, red blood cells actively participate in thrombin generation. A sub-fraction of red blood cells express phosphatidylserine on their surface and unlike platelets, red blood cells produce thrombin through the meizothrombin pathway, which has interesting consequences in the context of clot formation and stabilization.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Erythrocyte Membrane / metabolism*
  • Erythrocytes / metabolism*
  • Humans
  • Microscopy, Electron, Scanning / methods
  • Thrombin / biosynthesis*


  • Thrombin