New knowledge about the mechanism of blood coagulation and the many ways in which coagulation, fibrinolysis and inflammation interact in vivo, has substantially changed current thinking about these processes and related medical conditions.

This article deals with the functional interactions between these systems and the key role of some regulatory proteins, such as thrombin and a number of physiological anticoagulants.

Thrombin-activatable fibrinolysis inhibitor (TAFI) is a recently described enzyme that stabilizes blood clots by inhibiting fibrinolysis. It also inhibits inflammation by inactivating complement factor C5a.

Coagulation factor VIII also plays a role in the stabilisation of blood clots, fibrinolysis, the regulation of vascular permeability and inflammation.