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Role of Vitamin K in coagulation
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vitamin K p. 69
coagulation cascade p. 420
solubility of p. 63
warfarin reversal p. 726
for warfarin toxicity p. 249, 444
Vitamin K helps to regulate the process of blood coagulation by assisting in the conversion of certain coagulation factors into their mature forms. Without vitamin K, our bodies would be unable to control clot formation. Imagine being unable to form blood clots effectively--that would mean that we would lose all of our blood volume from something as simple as a pinprick! To prevent this extreme scenario - vitamin K must be ingested, metabolized, and utilized to create mature coagulation factors.
Now, to understand the regulation of clot formation, we first need to talk briefly about hemostasis, in which hemo refers to the blood, and stasis means to halt or stop. Hemostasis is divided into two phases: primary and secondary hemostasis. Primary hemostasis involves the formation of a platelet plug around the site of an injured blood vessel, and secondary hemostasis reinforces the platelet plug with the creation of a protein mesh called fibrin. To get to fibrin, a set of coagulation factors, each of which are enzymes, need to be activated. These enzymes are activated via a process called proteolysis- which is where a portion of the protein is clipped off. In total, there are twelve coagulation factors numbered factors I-XIII, there’s no factor VI. Most of these factors are produced by liver cells, and it turns out that producing coagulation factors II, VII, IX, and X requires an enzyme that uses vitamin K.
Vitamin K is found in abundance in green leafy foods—things like spinach, kale, and chard which all have high concentrations of vitamin K. It’s a fat-soluble vitamin, along with vitamins A, D, and E, meaning that it can be stored in fat cells instead of being excreted by the kidneys. Vitamin K is also synthesized by bacteria in our gastrointestinal tract as a byproduct of their metabolism, which further contributes to overall intake.
Vitamin K plays a crucial role in blood coagulation, which is the process by which the body forms clots to stop bleeding. Vitamin K acts as a cofactor for a group of proteins known as the vitamin K-dependent clotting factors (II, VII, IX, and X ), which are involved in the activation of blood-clotting proteins. To be useful, vitamin K undergoes a series of oxidation and reduction reactions called the vitamin K cycle.
Vitamin K deficiency can result in impaired blood clotting, leading to spontaneous bleeding or excessive bleeding from cuts or injuries. Newborn infants are at particular risk because they have limited stores of vitamin K, and are often not able to produce enough of the vitamin on their own. This is why they are typically given a single injection of vitamin K shortly after birth.
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