(Redirected from Factor Xa)
'Factor X', also known by the
eponym 'Stuart-Prower factor' or as 'thrombokinase', is an
enzyme () of the
coagulation cascade. It is a
serine endopeptidase (protease group S1).
Physiology
Factor X is synthesized in the
liver and requires
vitamin K for its synthesis.
Factor X is activated into ''factor Xa'' by both
factor IX (with its cofactor,
factor VIII in a complex known as ''intrinsic Xase'') and
factor VII with its cofactor,
tissue factor (a complex known as ''extrinsic Xase''). It is therefore the first member of the ''final common pathway'' or ''thrombin pathway''.
It acts by cleaving
prothrombin in two places (an
arg-
thr and then an
arg-
ile bond), which yields the active
thrombin. This process requires
factor V as a cofactor.
Factor Xa is inactivated by
protein Z-dependent protease inhibitor (ZPI), a
serine protease inhibitor (serpin). The affinity of this protein for factor Xa is increased 1000-fold by the presence of
protein Z, while it does not require protein Z for inactivation of
factor XI. Defects in protein Z lead to increased factor Xa activity and a propensity for thrombosis.
The half life of factor X is 40-45 hours.
Genetics
The human factor X
gene is located on the thirteenth
chromosome (13q34).
Role in disease
Inborn deficiency of factor X is very uncommon (1:500,000), and may present with
epistaxis (nosebleeds),
hemarthrosis (bleeding into joints) and gastrointestinal blood loss. Apart from congenital deficiency, low factor X levels may occur occasionally in a number of disease states.
Deficiency of vitamin K or antagonism by
warfarin (or similar medication) leads to the production of an inactive factor X. In warfarin therapy, this is desirable to prevent
thrombosis.
Therapeutic use
Factor X is not commercially available as a concentrate, but is part of
fresh frozen plasma and
prothrombin complex.
History
American and British scientists described deficiency of factor X independently in 1953 and 1956, respectively. As with some other coagulation factors, the factor was initially named after these patients, a Mr Rufus Stuart and a Miss Audrey Prower.
External links
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Factor X deficiency