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Platelet plug

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Platelet plug

The platelet plug, also known as the hemostatic plug or platelet thrombus, is an aggregation of platelets formed during early stages of hemostasis in response to one or more injuries to blood vessel walls. After platelets are recruited and begin to accumulate around the breakage, their “sticky” nature allows them to adhere to each other. This forms a platelet plug, which prevents more blood from leaving the body as well as any outside contaminants from getting in. The plug provides a temporary blockage of the break in the vasculature. As such, platelet plug formation occurs after vasoconstriction of the blood vessels but before the creation of the fibrin mesh clot, which is the more permanent solution to the injury. The result of the platelet plug formation is the coagulation of blood. It can also be referred to as primary hemostasis.

For many years, the critical role that platelets (also known as thrombocytes) played in hemostasis and blood coagulation went unnoticed by scientists. Even though the existence of platelets as a cell fragment was initially discovered in 1882, it took scientists until the 1960s before they moved their interest from the interaction of platelets with blood coagulation to the interaction of platelets with themselves.

The discovery of adenosine diphosphate (ADP) as the primary inducer of platelet aggregation was a major breakthrough in the field of hematology. It was followed by the discovery of the platelet release reaction, as well as the aggregating properties of thrombin and collagen.

The platelet plug formation is the second step of hemostasis. It occurs after vasoconstriction. During the process, platelets begin to accumulate, or aggregate, on the damaged vessel wall.[citation needed]

Platelet plug formation occurs in three major steps:

Under normal physiological conditions, blood flows through the body without any noticeable aggregation of platelets. This is because platelets are not initially programmed to accumulate by themselves because this could cause an undesirable thrombosis. However, during hemostasis, coagulation is desired. As such, the platelets in the plasma must be alerted to the need for a plug formation.[citation needed]

Any discontinuity detected in the vascular endothelium triggers an automatic response in the clotting system, which in turns stimulates thrombin production. Thrombin also causes platelet aggregation.

As such, more often than not, platelet adhesion and activation occur in overlapping steps, where one directly influences and contributes to the other.

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