Tissue Factor Pathway Inhibitor: Multiple Anticoagulant Activities for a Single Protein.
Review published in Arteriosclerosis, thrombosis, and vascular biology (2015)
Abstract
Tissue factor (TF) pathway inhibitor (TFPI) is an anticoagulant protein that inhibits early phases of the procoagulant response. Alternatively spliced isoforms of TFPI are differentially expressed by endothelial cells and human platelets and plasma. The TFPIβ isoform localizes to the endothelium surface where it is a potent inhibitor of TF-factor VIIa complexes that initiate blood coagulation. The TFPIα isoform is present in platelets. TFPIα contains a stretch of 9 amino acids nearly identical to those found in the B-domain of factor V that are well conserved in mammals. These amino acids provide exosite binding to activated factor V, which allows for TFPIα to inhibit prothrombinase during the initiation phase of blood coagulation. Endogenous inhibition at this point in the coagulation cascade was only recently recognized and has provided a biochemical rationale to explain the pathophysiological mechanisms underlying several clinical disorders. These include the east Texas bleeding disorder that is caused by production of an altered form of factor V with high affinity for TFPI and a paradoxical procoagulant effect of heparins. In addition, these findings have led to ideas for pharmacological targeting of TFPI that may reduce bleeding in hemophilia patients.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Tissue factor (TF) pathway inhibitor (TFPI) is an anticoagulant protein that inhibits early phases of the procoagulant response. Alternatively spliced isoforms of TFPI are differentially expressed by endothelial cells and human platelets and plasma.
Por qué esto importa para la hirudoterapia
Esta revisión examina el inhibidor de la vía del factor tisular (TFPI), una proteína anticoagulante con isoformas con ayuste alternativo expresadas diferencialmente por células endoteliales y plaquetas. La isoforma TFPIα contiene aminoácidos casi idénticos al dominio B del factor V, lo que permite la unión al exosito del factor V activado y la inhibición de la protrombinasa durante la iniciación de la coagulación. Estos hallazgos explican trastornos clínicos como el trastorno hemorrágico del este de Texas y un efecto procoagulante paradójico de las heparinas, y sugieren el direccionamiento farmacológico de TFPI para la hemofilia. Para el dominio de ASH, el artículo contribuye a la comprensión de los mecanismos anticoagulantes endógenos relevantes para el campo más amplio de la ciencia de la anticoagulación. Sin embargo, no se mencionan sanguijuelas, hirudoterapia ni el secretoma de la sanguijuela, y la conexión con el dominio de ASH se limita a la biología general de la coagulación.
Citación
Tissue Factor Pathway Inhibitor: Multiple Anticoagulant Activities for a Single Protein.
Mast · Arteriosclerosis, thrombosis, and vascular biology, 2015
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Añadido a la biblioteca ASH: May 28, 2026 · Última actualización del sitio: 18 de junio de 2026