American Society of Hirudotherapy

The Coagulant Factor Xa Induces Protease-Activated Receptor-1 and Annexin A2-Dependent Airway Smooth Muscle Cytokine Production and Cell Proliferation

Research article published in American journal of respiratory cell and molecular biology (2016)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Research reportDrug DevelopmentSchuliga M et al. · American journal of respiratory cell and molecular biology, 2016

Abstract

During asthma exacerbation, plasma circulating coagulant factor X (FX) enters the inflamed airways and is activated (FXa). FXa may have an important role in asthma, being involved in thrombin activation and an agonist of protease-activated receptor-1 (PAR-1). Extracellular annexin A2 and integrins are also implicated in PAR-1 signaling. In this study, the potential role of PAR-1 in mediating the effects of FXa on human airway smooth muscle (ASM) cell cytokine production and proliferation was investigated. FXa (5-50 nM), but not FX, stimulated increases in ASM IL-6 production and cell number after 24- and 48-hour incubation, respectively (P < 0.05; n = 5). FXa (15 nM) also stimulated increases in the levels of mRNA for cytokines (IL-6), cell cycle-related protein (cyclin D1), and proremodeling proteins (FGF-2, PDGF-B, CTGF, SM22, and PAI-1) after 3-hour incubation (P < 0.05; n = 4). The actions of FXa were insensitive to inhibition by hirudin (1 U/ml), a selective thrombin inhibitor, but were attenuated by SCH79797 (100 nM), a PAR-1 antagonist, or Cpd 22 (1 μM), an inhibitor of integrin-linked kinase. The selective targeting of PAR-1, annexin A2, or β1-integrin by small interfering RNA and/or by functional blocking antibodies also attenuated FXa-evoked responses. In contrast, the targeting of annexin A2 did not inhibit thrombin-stimulated ASM function. In airway biopsies of patients with asthma, FXa and annexin A2 were detected in the ASM bundle by immunohistochemistry. These findings establish FXa as a potentially important asthma mediator, stimulating ASM function through actions requiring PAR-1 and annexin A2 and involving integrin coactivation.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeJournal ArticleResearch Support, Non-U.S. Gov't
Indexed MeSH termsAirway RemodelingAnnexin A2AsthmaBiopsyCell ProliferationCells, CulturedCytokinesDose-Response Relationship, DrugFactor XaGene Expression RegulationHumansIntegrin beta1

Summary

During asthma exacerbation, plasma circulating coagulant factor X (FX) enters the inflamed airways and is activated (FXa).

Why This Matters for Hirudotherapy

This study investigated whether coagulant Factor Xa stimulates human airway smooth muscle (ASM) cell cytokine production and proliferation via PAR-1 and annexin A2, relevant to asthma airway remodeling. The abstract reports that FXa's effects were insensitive to hirudin (1 U/ml), which the abstract itself identifies as a selective thrombin inhibitor, but were attenuated by a PAR-1 antagonist, an integrin-linked kinase inhibitor, and targeting of PAR-1, annexin A2, or β1-integrin. FXa and annexin A2 were also detected in ASM bundles of asthma patients via biopsy immunohistochemistry. For ASH, relevance is limited and indirect: hirudin appears only as a laboratory reagent to help distinguish FXa-mediated from thrombin-mediated effects, with no leeches, no hirudotherapy, and no therapeutic application of hirudin.

Citation

The Coagulant Factor Xa Induces Protease-Activated Receptor-1 and Annexin A2-Dependent Airway Smooth Muscle Cytokine Production and Cell Proliferation

Schuliga M et al. · American journal of respiratory cell and molecular biology, 2016

Added to ASH library: May 27, 2026 · Site last updated: June 18, 2026

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