[ed note: Longtime commenter and reader Dr. KSS, a medical doctor and biotech investor, has agreed to share his thoughts with the Irregulars as one of our guest authors, educating us on health and medicine and sharing some of his biotech investing ideas. He has agreed to the same basic trading restrictions as other paid contributors (he will not trade a stock for three days after his article is published, except current orders that are disclosed in the article, and will disclose ownership of stocks covered in his commentary). He comes up with his own topics, and his thoughts and opinions are his alone. Enjoy!]
Earlier this year in a Stock Gumshoe biotech thread, our very own Frank Archambeau posted a comment of mind-blowing profundity. To paraphrase, how could nature, he asked, which is invariably about chaos and disorder, ever have come up with something as insanely complex and fine-tuned as living systems are? This is especially relevant when one considers what may the be most exquisitely balanced and controlled of all systems in mammals: coagulation.
Coagulation is a process by which, in response to injury, blood renders previously soluble proteins insoluble to plug a wound, and does so quickly, but in a way that confines the insoluble proteins to the site of the wound, without letting clotting extend to occupy all the vessels. And it does this in such a way as to also enable slow dissolving of the clot. That it does so has kept me rapt since undergraduate school, and spellbound me so much as a first-year medical student that I decided to do a PhD in the biochemistry and molecular biology of coagulation. A team of the smartest scientists and physicians in the world could never have designed so exquisite a system. Nature devised this, and has been finely adjusting it, incrementally improving it, for millions of years. Monet never painted something as lovely as the clotting system.
Here is a simplified diagram of the coagulation “cascades,” the reactions leading to clotting.
If you are a physician and you went to medical school before 1990, you were taught that for clotting of blood, only the intrinsic pathway (on the left) mattered. As is often the case in intellectual pursuits, pendulums swing, however, and if you went to medical school after 1990, you were taught that only the extrinsic pathway (on the right) mattered. The coagulation ...
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