The convergent model of coagulation.

It is increasingly apparent that the pathological interplay between coagulation and innate immunity, i.e. immunothrombosis, forms the common basis of many challenges across the boundaries of specialised medicine and cannot be fully explained by the conventional concepts of cascade and cell-based coagulation. To evolve coagulation understanding, we propose a model of coagulation which converges with inflammation and innate immune activation as a unified response towards vascular injury. Evolutionarily integral to the convergent response are damage-associated molecular patterns (DAMPs), which are released as a consequence of injury. DAMPs facilitate diverse interactions within and between systems, not only to complement and reinforce cell-based clot formation but also to steer the response towards clot resolution and wound healing. By extending coagulation beyond its current boundaries, the convergent model aims to deliver novel diagnostics and therapeutics for contemporary and unexpected challenges across medicine, as exposed by COVID19 and vaccine-induced immune thrombotic thrombocytopenia.

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