Tissue factor pathway inhibitor and the current concept of blood coagulation.
Tissue factor pathway inhibitor (TFPI) is a multivalent, Kunitz-type plasma proteinase inhibitor that regulates tissue factor-induced coagulation. TFPI directly inhibits activated factor X and, in a factor Xa-dependent manner, produces feedback inhibition of the factor VIIa/tissue factor catalytic complex. The properties of this inhibitor help explain the clinical need for 'extrinsic' and 'intrinsic' coagulation pathways and have led to a reformulation of the coagulation cascade. In the revised hypothesis, factor VIIa/tissue factor is responsible for the initiation of coagulation but, owing to TFPI-mediated feedback inhibition, amplification of the procoagulant response though the actions of factor VIII, IX and XI is required for sustained haemostasis.
Broze
G J
GJ
Division of Hematology/Oncology, Jewish Hospital, Washington University Medical Center, St Louis, MO 63110, USA.
D000595:Amino Acid Sequence; D001777:Blood Coagulation; D015942:Factor VIIa / Q000378:metabolism; D005170:Factor X / Q000037:antagonists & inhibitors; D006801:Humans; D008074:Lipoproteins / Q000737:chemistry / Q000502:physiology*; D008969:Molecular Sequence Data; D015842:Serine Proteinase Inhibitors
D008074:Lipoproteins; D015842:Serine Proteinase Inhibitors; C051928:lipoprotein-associated coagulation inhibitor; D005170:Factor X; D015942:Factor VIIa