Fig. 4.

EVs in coagulation.

Haemostasis: Originating from various sources (monocytes, endothelial cells, platelets), procoagulant (tissue factor (TF)-EVs and phosphatidylserine (PS)-bearing EVs) and anticoagulant, as well as pro-fibrinolytic EVs may circulate at low levels in normal, healthy blood, contributing to the maintenance of the homeostatic balance in blood coagulation. Up-regulated coagulation or thrombosis: Various clinical conditions (cancer, cardiovascular diseases, inflammation, diabetes, sepsis and others) may trigger the coagulation system, activating circulating monocytes and platelets, making endothelial cells procoagulant and resulting in increased generation of procoagulant EVs, particularly TF–EVs, thus leading to a hypercoagulable condition with thrombotic events, hallmarked with fibrin formation and platelet entrapment (thrombus formation).