Unusual zymogen activation patterns in the protein corona of Ca-zeolites

Zymogen (prothrombin) activation is central to the process of haemostasis (blood clotting) in the body, preventing serious blood loss and death from haemorrhagic shock. Zeolites comprise a family of crystalline microporous aluminosilicates that show increasing promise for use in massive bleeding control. However, the mechanism of zeolite-initiated haemostasis has remained unclear. Here, we investigate zeolite-initiated thrombin activation at the molecular level, and show that a prothrombinase complex can assemble on the inorganic surface of calcium-ion-exchanged zeolites (Ca-zeolites). Compared to natural platelet-based physiological processes, prothrombin-to-thrombin conversion on the surface of Ca-zeolite displays a striking thrombin activation pattern, with an exceptionally high plateau thrombin activity and at least 12-fold enhanced endogenous thrombin. The results provide a mechanistic understanding of how the zeolite surface functionally contributes to thrombin activation, paving the way towards the design of improved agents for bleeding management. [Figure not available: see fulltext.]