Inhibition of factor VIIa/tissue factor (TF) by extrinsic pathway inhibitor (EPI)
requires the participation of factor Xa. Through this inhibition, factor Xa generated
initially may feed back to suppress continuing generation of factor Xa via the extrinsic
pathway during hemostasis. We have utilized chemical modifications of EPI and factor
Xa to study the reactions responsible for inhibition. The data are consistent with
a two-step model. First, EPI binds to factor Xa in a Ca2+ independent reaction in which the gla-domain of factor Xa does not participate. A
functional active site on factor Xa and arginine residues on EPI are essential for
this step. Then the factor Xa/EPI complex binds to factor VIIa/TF with resultant inhibition
of its enzymatic activity. The gla-domain of factor Xa is essential for this step.
Intact positively charged lysines on factor Xa may also be important
Keywords
Extrinsic pathway inhibitor - Tissue factor - Factor VIIa - Factor Xa - Γ-Carboxyglutamic
acid