A zymogen-like factor Xa variant corrects the coagulation defect in hemophilia

L Ivanciu, R Toso, P Margaritis, G Pavani, H Kim… - Nature …, 2011 - nature.com
L Ivanciu, R Toso, P Margaritis, G Pavani, H Kim, A Schlachterman, JH Liu, V Clerin…
Nature biotechnology, 2011nature.com
Effective therapies are needed to control excessive bleeding in a range of clinical
conditions. We improve hemostasis in vivo using a conformationally pliant variant of
coagulation factor Xa (FXaI16L) rendered partially inactive by a defect in the transition from
zymogen to active protease,. Using mouse models of hemophilia, we show that FXaI16L has
a longer half-life than wild-type FXa and does not cause excessive activation of coagulation.
Once clotting mechanisms are activated to produce its cofactor FVa, FXaI16L is driven to the …
Abstract
Effective therapies are needed to control excessive bleeding in a range of clinical conditions. We improve hemostasis in vivo using a conformationally pliant variant of coagulation factor Xa (FXaI16L) rendered partially inactive by a defect in the transition from zymogen to active protease,. Using mouse models of hemophilia, we show that FXaI16L has a longer half-life than wild-type FXa and does not cause excessive activation of coagulation. Once clotting mechanisms are activated to produce its cofactor FVa, FXaI16L is driven to the protease state and restores hemostasis in hemophilic animals upon vascular injury. Moreover, using human or murine analogs, we show that FXaI16L is more efficacious than FVIIa, which is used to treat bleeding in hemophilia inhibitor patients. FXaI16L may provide an effective strategy to enhance blood clot formation and act as a rapid pan-hemostatic agent for the treatment of bleeding conditions.
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