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The generation of bradykinin by contact activation requires autoactivation of factor XII (Hageman factor) upon initiating surfaces, conversion of prekallikrein to kallikrein, and digestion of high-molecular-weight (HMW) kininogen. Endothelial cells have a high-affinity receptor that binds either HMW kininogen or factor XII in a zinc-dependent interaction, and activation of factor XII can occur along this surface to initiate kinin formation. Tissue injury, exposure of proteoglycans, or release of mast cell heparin will markedly accelerate these reactions. The bradykinin released binds to endothelial cell B-2 receptors along the inner surface of blood vessels which results in dilatation and increased vascular permeability.

Assembly of the Human Plasma Kinin-Forming Cascade along the Surface of Vascular Endothelial Cells