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New insights into the biology of tissue factor pathway inhibitor #MMPMID26149025
MARONEY SA; MAST AE
J Thromb Haemost 2015[Jun]; 13 (0 1): S200-7 PMID26149025show ga
Tissue factor pathway inhibitor (TFPI) dampens the initiation of blood coagulation by inhibiting two potent procoagulant complexes, tissue factor?factor VIIa (TF?FVIIa) and early forms of prothrombinase. TFPI isoforms, TFPI? and TFPI?, result from alternative splicing of mRNA, producing distinct C-terminal ends of the two proteins. Both isoforms inhibit TF?FVIIa, but only TFPI? can inhibit early forms of prothrombinase by binding of its positively charged C-terminus with high affinity to the acidic B-domain exosite of FVa, which is generated upon activation by FXa. TFPI? and TFPI? are produced in cultured human endothelial cells, while platelets contain only TFPI?. Knowledge of the anticoagulant mechanisms and tissue expression patterns of TFPI? and TFPI? have improved our understanding of the phenotypes observed in different mouse models of TFPI deficiency, the east Texas bleeding disorder, and the development of pharmaceutical agents that block TFPI function to treat hemophilia.