Rethinking coagulation: from enzymatic cascade and cell-based reactions to a convergent model involving innate immune activation

Advancements in hemostasis and thrombosis have evolved through major developments in health research over several decades.

• The cascade model of coagulation was first described in the 1960s, emphasizing a sequence of biochemical reactions.
• The cell-based model, which includes cellular coordination in clot formation, emerged around the turn of the millennium.
• Current thrombotic challenges, particularly during the COVID-19 pandemic, have highlighted limitations in existing concepts and treatment responses.
• Innate immune activation appears to be integrated with adaptive clot formation, influencing both immunity and coagulation processes.
• The review discusses key molecules that facilitate interactions between immunity, inflammation, and coagulation, suggesting an evolved understanding of these interconnected systems.

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