Details:You will choose a subject area from those presented in lectures throughout the semester (weeks 1-11) and research and write an assignment of 1500 words on this research area or technique....

Title: Influence of Haemophilia on wound healing
Haemophilia is a hereditary X-linked recessive congenital disorder in which the patient lacks the coagulation factor essential for blood clotting. Haemophilia A and Haemophilia B are the most common haemorrhagic ailments that occurred due to the deficiency of factor VIII and factor IX respectively. VIII. Nearly 85% of haemophiliacs have ‘type A’ haemophilia. Thrombin formation is distinctly diminished in haemophilia, and hence a stable haemostatic plug not formed. Due to this, the blood clotting ability of the person gets severely reduced and hence even with the minor injury lots of bleeding occurs in the sufferers [1]. Haemophilia is basically triggered due to the mutation in the genes which are located on the X chromosome and responsible for producing these clotting factor proteins. These blood clotting proteins are essential for the production of blood clot during wound healing. The severity of disease rest on the type of mutation that occurred in these genes and level of reduction of the clotting factor VIII or IX proteins. Reduction, alteration or absence of these clotting factors results in excessive bleeding after surgery or due to cuts, abrasions and delayed the process of wound healing [2]. Normally the process of wound healing takes places in four overlapping stages- haemostasis, inflammation, proliferation, and remodelling. As the vessel gets ruptured, the haemostatic phase begins. In this, the platelets get adhered to the extracellular matrix and start releasing the platelet-derived growth factor and transforming growth factors. Due to the release of these factors, procoagulant enzymes get activated and produces thrombin, which further forms the stable fibrin clot. Fibrin acts as the framework for tissue repair in the inflammatory phase and promotes the influx of lymphocytes, macrophages and neutrophils at the wounded site which forms the first line of defence against microbial invasion. Later in proliferative phase, regeneration of epidermis, angiogenesis and proliferation of fibroblast takes place which helps in the filling of the wounded site. Finally in remodelling phase, that continues for weeks or even months, collagen reorganizes at the wounded site and scar forms [3,4].
Maurene et al in 2006 [5] reported in their research article that the haemostatic process is essential as it stops blood loss and provides biologically active components like thrombin essential for succeeding healing and inflammatory responses. Hence, adequate haemostatic phase is essential for the process of wound healing. In case of haemophilia, thrombin generation gets impaired and thus affects the overall healing rate. Since, thrombin is mainly responsible for angiogenesis, hence angiogenesis gets severely impaired in Haemophilia due to reduction or absence of thrombin. Hoffman et al in 2010 [6] mentioned that in patients of haemophilia compact invasion of inflammatory cells and transformed rate of angiogenesis is mostly observed at the wounded site. Along with this, they faced recurrent incidents of re-bleeding and advanced accretion of iron in the...