Tissue Factor Pathway Inhibitor

Following activation of coagulation by exposure of plasma Factor VII to tissue factor, coagulation proceeds through an ordered series of proteolytic steps. The rate and extent of coagulation are controlled by a number of mechanisms, including the exposure of tissue factor to plasma coagulation factors, the formation of a proper surface onto which the proteolytic reactions take place, and protein inhibitors of coagulation, including antithrombin III and activated protein C. The tissue factor pathway inhibitor (TFPI; previously known as the extrinsic pathway inhibitor or the lipoprotein-associated coagulation inhibitor) is a recently characterized inhibitor of coagulation that should now be considered alongside antithrombin III and protein C as a physiologically significant natural anticoagulant. In this review, I shall give a brief and superficial description of the tissue factor pathway inhibitor, emphasizing what is known about its normal physiology and potential as a therapeutic agent. Readers wanting more detail can study one or more of the recent reviews of the tissue factor pathway inhibitor.

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