jess, I'm a believer. thrombin activates par receptors and they control a bunch of downstream things. thrombin floats around in the blood and antithrombin follows it around. when things go wrong the two end up at the scene of the crime at the same time. A lot happens thereafter, some in the blood, some inside the cells. In the case of apoptosis or necrosis, or whatever osis, there is a proteolytic signal that is transmitted from the blood to the nucleus/mitochondria, across membranes.