Tissue factor pathway inhibitor

Common pathway · detail · Endothelial Kunitz

A Kunitz-type inhibitor made by endothelium that binds factor Xa and then the TF-VIIa complex, shutting the extrinsic trigger down after only trace amounts of Xa have been produced. Once TFPI has quenched initiation, continued thrombin generation depends entirely on the intrinsic tenase — which is precisely why haemophilia bleeds despite an intact extrinsic pathway.

Traced from the start

  1. Tissue factor and the extrinsic triggerVitamin K cycle and gamma-carboxylation
  2. Tissue factor-factor VIIa complex (extrinsic tenase)
  3. Tissue factor pathway inhibitor

Detail

Source
Vascular endothelium; most of the circulating pool is lipoprotein-bound and is released into plasma by heparin
Inhibits
Factor Xa first, then the resulting Xa-TF-VIIa quaternary complex
Consequence
Initiation is self-limiting, making amplification through factors XI, VIII and V obligatory for a durable clot
Drug target
Concizumab and marstacimab block TFPI to restore thrombin generation in haemophilia, including in patients with inhibitors

Practise this structure

No question in the bank is tagged to Tissue factor pathway inhibitor yet. Questions appear here automatically once one is — the question bank is free to browse in the meantime.