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FACTOR X

(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).

Contents
Physiology
Genetics
Role in disease
Therapeutic use
History
External links

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





Factor X deficiency

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