Protein Information

Name protein a
Synonyms A1 activator; PSAP; Protein C; CSAct; Cerebroside sulfatase activator; Cerebroside sulfate activator; Co beta glucosidase; Component C…

Compound Information

Name warfarin
CAS

Reference List

PubMed Abstract RScore(About this table)
19391630 Yasuo K, Yamaotsu N, Gouda H, Tsujishita H, Hirono S: Structure-based CoMFA as a predictive model - CYP2C9 inhibitors as a test case. J Chem Inf Model. 2009 Apr;49(4):853-64.


This scheme consists of a search for ligand-binding sites on a protein, a generation of bound conformations (poses) of ligands in each of the sites by docking, identifications of the correct poses of each ligand by consensus scoring and MM-PBSA analysis, and a construction of a CoMFA model with the obtained poses to predict the affinity of the ligands.
1(0,0,0,1) Details
20337814 Di Giacomo TB, Hussein TP, Souza DG, Criado PR: Frequency of thrombophilia determinant factors in patients with livedoid vasculopathy and treatment with anticoagulant drugs - a prospective study. J Eur Acad Dermatol Venereol. 2010 Mar 13.

Methods Thirty-four LV patients were tested for prothrombin time, activated partial thromboplastin time, antithrombin activity, protein C and S activity, anticardiolipin antibodies, lupus anticoagulant, prothrombin gene mutation, factor V Leiden mutation, methylenetetrahydrofolate reductase mutation, plasma homocysteine and fibrinogen.
Thirteen of these patients were treated with anticoagulant drugs (either warfarin or heparin).
1(0,0,0,1) Details
19002753 Watanabe M, Aoki M, Fujiwara T: Thrombotic occlusion of Blalock-Taussig shunt in a patient with unnoticed protein C deficiency. Gen Thorac Cardiovasc Surg. 2008 Nov;56(11):544-6. Epub 2008 Nov 12.

Examination of coagulation factors revealed low levels of both the amount and activity of protein C (27% and 31%, respectively).
Diagnosis of heterozygous hereditary protein C deficiency was made, and the patient was placed on warfarin.
1(0,0,0,1) Details
18549908 Pabinger-Fasching I: Warfarin-reversal: results of a phase III study with pasteurised, nanofiltrated prothrombin complex concentrate. Thromb Res. 2008;122 Suppl 2:S19-22.

Beriplex P/N contains high concentrations of the coagulation factors II, VII, IX and X, together with the inhibitors protein C and protein S, and it can be rapidly prepared and administered at an infusion rate of up to 8.0 mL/min.
1(0,0,0,1) Details
18841275 Vasse M: Protein Z, a protein seeking a pathology. Thromb Haemost. 2008 Oct;100(4):548-56.

Protein Z (PZ) is a vitamin K-dependent factor identified in human plasma in 1984 characterized by an homology with other vitamin K-dependent factors (factor VII, IX, X, protein C).
In humans, PZ is characterized by an unusual wide distribution in plasma, and a major decrease induced by warfarin.
1(0,0,0,1) Details
18373620 Dargaud Y, Desmurs-Clavel H, Marin S, Bordet JC, Poplavsky JL, Negrier C: Comparison of the capacities of two prothrombin complex concentrates to restore thrombin generation in plasma from orally anticoagulated patients: an in vitro study. J Thromb Haemost. 2008 Jun;6(6):962-8. Epub 2008 Mar 27.

The difference in the correction of TG capacity observed between the two drugs could be explained by a variable increase in FX, FVII and protein C with similar doses.
BACKGROUND: Human prothrombin complex concentrates (PCCs) are used for prevention and treatment of bleeding episodes in patients under warfarin therapy.
1(0,0,0,1) Details
18549907 Wiedermann CJ, Stockner I: Warfarin-induced bleeding complications - clinical presentation and therapeutic options. Thromb Res. 2008;122 Suppl 2:S13-8.

In addition, PCC is associated with a more rapid normalisation of the INR and a better clinical outcome due to the balanced ratio of four vitamin-K-dependent clotting factors plus the coagulation inhibitors protein C and Protein S.
1(0,0,0,1) Details
18840163 Hiroe S, Itoh H, Matsumoto H, Takahasi S, Sato Y, Yamada S, Okagaki A, Kuzushita N, Ban C: Case of Budd-Chiari syndrome 3 months after vaginal delivery. J Obstet Gynaecol Res. 2008 Aug;34(4 Pt 2):605-8.

Her protein C antigen and activity were 37% and 50%, respectively, corresponding to type 1 protein C deficiency.
Conservative treatment by continuous oral treatment of spironolactone (25 mg/day), furosemide (20 mg/day) and prophylactic warfarin (2 mg/day) much improved the ascites.
1(0,0,0,1) Details
18461056 Hofherr SE, Shashkova EV, Weaver EA, Khare R, Barry MA: Modification of adenoviral vectors with polyethylene glycol modulates in vivo tissue tropism and gene expression. Mol Ther. 2008 Jul;16(7):1276-82. Epub 2008 May 6.

When protein C (PC) and factors VII, IX, and X were added, only factors IX and X increased transduction by the PEGylated vectors with the largest effect by X.
Inactivation of these factors with warfarin drastically reduced liver transduction in mice by the PEGylated vectors after intravenous (i.v.) injection.
1(0,0,0,1) Details
19144654 Lapecorella M, Napolitano M, Bernardi F, Pinotti M, Sbrighi PS, Marchetti G, Canella A, Caruso P, Orecchioni A, Mariani G: Effective hemostasis during minor surgery in a case of hereditary combined deficiency of vitamin K-dependent clotting factors. Clin Appl Thromb Hemost. 2010 Apr;16(2):221-3. Epub 2009 Jan 13.

Combined deficiency of the vitamin K-dependent clotting factors (VKCFD) is a rare bleeding disorder involving defective gamma-carboxylation of coagulation factors II , VII, IX and X as well as natural anticoagulants protein C and protein S.
As this disease is a natural model that resembles oral anticoagulation, our experience discloses a possible rationale in the use of recombinant activated FVII for warfarin reversal.
1(0,0,0,1) Details
19380668 Kalajian AH, Malhotra PS, Callen JP, Parker LP: Calciphylaxis with normal renal and parathyroid function: not as rare as previously believed. Arch Dermatol. 2009 Apr;145(4):451-8.


Analysis of this case and the 13 previously reported cases of nontraditional calciphylaxis identified the following patient characteristics that highlight clinical situations potentially predisposing to calciphylaxis: hypoalbuminemia, malignant neoplasm, systemic corticosteroid use, anticoagulation with warfarin sodium or phenprocoumon, chemotherapy, systemic inflammation, hepatic cirrhosis, protein C or S deficiency, obesity, rapid weight loss, and infection.
1(0,0,0,1) Details
19811220 Flores-Nascimento MC, Beltrame MP, De Paula EV, Montalvao SL, Pereira FG, Orsi FL, Lorand-Metze I, Annichino-Bizzacchi JM: Microparticles in deep venous thrombosis, antiphospholipid syndrome and Factor V Leiden. Platelets. 2009 Sep;20(6):367-75.

Even the increased MPs from patients 1-3 years after thrombotic episode generated lower amount of thrombin, they can have a protective effect by activation of Protein C anticoagulant pathway.
This study compared the number, cellular origin and procoagulant activity of MPs on DVT patients in different clinical situations: at diagnosis (n = 9, 5F/4M; mean age = 41.11), 1-3 years after warfarin withdrawal (n = 10, 7F/3M; mean age = 32.90), associated to antiphospholipid syndrome (APS; n = 11, 9F/2M; mean age = 33.82), or asymptomatic carriers of Factor V Leiden (FVL; n = 7, 7F/0M; mean age = 34.00) vs healthy controls (CTR).
1(0,0,0,1) Details
20004955 Szlam F, Luan D, Bolliger D, Szlam AD, Levy JH, Varner JD, Tanaka KA: Anti-factor IXa Aptamer reduces propagation of thrombin generation in plasma anticoagulated with warfarin. Thromb Res. 2009 Dec 9.

First, a computer simulated time course of TG with warfarin alone and in combination with FIXa inhibition was evaluated and, second, normal volunteer, protein C deficient, FVII deficient and commercial warfarin plasmas (INR 2.1 and 3.1) were spiked with increasing concentrations of aptamer (0-24microg/ml) and its anticoagulant effects were evaluated using prothrombin time (PT), activated partial thromboplastin time (aPTT) and TG with tissue factor and Actin as activators.
88(1,1,2,3) Details
18294668 Maeda M, Murakami M, Takegami T, Ota T: Promotion or suppression of experimental metastasis of B16 melanoma cells after oral administration of lapachol. Toxicol Appl Pharmacol. 2008 Jun 1;229(2):232-8. Epub 2008 Jan 26.

Six hours after oral administration of lapachol or warfarin, the protein C level was reduced maximally, without elongation of prothrombin time.
31(0,1,1,1) Details
18376272 Tcheng WY, Dovat S, Gurel Z, Donkin J, Wong WY: Severe congenital protein C deficiency: description of a new mutation and prophylactic protein C therapy and in vivo pharmacokinetics. J Pediatr Hematol Oncol. 2008 Feb;30(2):166-71.

Long-term management and outcome is dependent on effective anticoagulation with warfarin, low-molecular weight heparin, or protein C concentrate.
11(0,0,1,6) Details
18416208 Kumano N, Ikeda S, Arimori Y, Ono T, Saeki S: [Heparin resistance associated with elevated factor VIII] . Masui. 2008 Apr;57(4):471-3.

The low values of protein C, protein S, and factor VII may have been caused by warfarin.
7(0,0,1,2) Details
18676288 Vural M, Usta S, Kaya R: Warfarin-induced benign acral cutaneous lesions in two cardiac patients with decreased protein C and S activity. Anadolu Kardiyol Derg. 2008 Aug 7;8(4):E22.
6(0,0,1,1) Details
19918503 Boys JA, Medaugh CJ, Hassouna HI: Assessment of specific risks for the recurrence of deep vein thrombosis: a case report. Cases J. 2009 Aug 24;2:7024.


The reduced form of vitamin K is an essential cofactor in the formation of active clotting factors II, VII, IX, X and regulatory factors protein C, and cofactor protein S through gamma-glutamyl carboxylation.
2(0,0,0,2) Details
19920886 Attia FM, Mikhailidis DP, Reffat SA: Prothrombin Gene G20210A Mutation in Acute Deep Venous Thrombosis Patients with Poor Response to Warfarin Therapy. Open Cardiovasc Med J. 2009 Oct 21;3:147-51.

Blood samples were also assessed for protein C, protein S, anti-thrombin III and anticardiolipin antibodies (ACA) levels.
2(0,0,0,2) Details
19127082 Imberti D, Pierfranceschi MG: Successful protein C concentrate administration during initiation of oral anticoagulation in adult patients with severe congenital protein C deficiency: report of two cases. Pathophysiol Haemost Thromb. 2008;36(2):53-7. Epub 2009 Jan 5.

These results have been obtained within a short time, thus allowing a safe administration of a loading dose of warfarin.
2(0,0,0,2) Details
18975602 Kitagawa Y, Ohkuma H, Tokuoka K: [Ischemic stroke with antiphospholipid antibody] . Brain Nerve. 2008 Oct;60(10):1144-58.


Activation of protein C is impaired in patients with aPL.
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