Tissue factors

It is truly possible to imagine the characteristics of an ideal radiopharmaceutical only in the context of a specific disease and organ system to which it might be appHed. Apart from the physical factors related to the radioisotope used, the only general characteristic that is important in defining the efficacy of these materials is the macroscopic distribution in the body, or biodistribution. This time-dependent distribution at the organ level is a function of many parameters which may be divided into four categories factors related to deUvery of the radiopharmaceutical to a particular tissue factors related to the extraction of the compound from circulation factors related to retention of the compound by that tissue and factors deterrnined by clearance. The factors in the last set are rarely independent of the others. 

Dennis, M.S., Lazarus, R.A. Kunitz domain inhibitors of tissue factor-factor Vila. 1. Potent inhibitors selected from libraries by phage display. /. Biol. Chem. 269 22129-22136, 1994. 

The antiinflammatory effects of statins likely result from their ability to inhibit the formation of mevalonic acid. Downstream products of this molecule include not only the end product, cholesterol, but also several isoprenoid intermediates that covalently modify ( pre-nylate ) certain key intracellular signaling molecules. Statin treatment reduces leukocyte adhesion, accumulation of macrophages, MMPs, tissue factor, and other proinflammatory mediators. By acting on the MHC class II transactivator (CIITA), statins also interfere with antigen presentation and subsequent T-cell activation. Statin treatment can also limit platelet activation in some assays as well. All these results support the concept that in addition to their favorable effect on the lipid profile, statins can also exert an array of antiinflammatory and immunomodulatory actions. 

Primarily, tissue factor pathway inhibitor (TFPI) binds to and inactivates FXa. In a second step TFPI/... 

FXa complexes bind to and neutralize tissue factor/ FVIIa complexes, the key starting point of the extrinsic clotting cascade (see earlier) (Fig. 7). Heparin is able to enhance this reaction by direct binding to the complex and by releasing TFPI from the unaltered vessel wall, which then can access the TF-exposing surface. 

Prothrombin time (PT) is a coagulation assay, which measures the time for plasma to clot upon activation by thromboplastin (a mixture of tissue factor and phospholipids). 

Tissue factor (TF) is an integral membrane glycoprotein, which is tightly associated with phospholipid (molecular weight 44 kDa). It is located on most... 

PAMPs and various tissue factors can prime DCs to produce T-cell-polarizing factors [21], IL-12 is a pro-inflammatory cytokine that induces IFN-y and promotes the development of Thl-cell differentiation [31], Other Thl-polarizing factors are IFN-a and IFN-(3 [32] and cell-surface expressed intracellular adhesion molecule (ICAM)-l [33]. On the other hand, it has been shown that NF-kB inducing kinase (NIK), which is known to regulate B-cell maturation and lymphoid organogenesis, is important for the induction of Thl7 cells [34],... 

Figure 51-1. The pathways of blood coagulation. The intrinsic and extrinsic pathways are indicated. The events depicted below factor Xa are designated the final common pathway, culminating in the formation of cross-linked fibrin. New observations (dotted arrow) include the finding that complexes of tissue factor and factor Vila activate not only factor X (in the classic extrinsic pathway) but also factor IX in the intrinsic pathway, in addition, thrombin and factor Xa feedback-activate at the two sites indicated (dashed arrows). (PK, prekallikrein HK, HMW kininogen PL, phospholipids.) (Reproduced, with permission, from Roberts HR, Lozier JN New perspectives on the coagulation cascade. Hosp Pract [Off Ed] 1992Jan 27 97.)...

Fibrinogen -i These factors are usually referred Prothrombin J to by their common names. Tissue factor -i These factors are usually not re-Ca + J ferred to as coagulation factors. 

Activated on surface of activated platelets by tenase complex (Ca, factors Villa and IXa) and by factor Vila in presence of tissue factor and Ca. ... 

Tissue factor pathway inhibitor (TFPI) is a major physiologic inhibitor of coagulation. It is a protein that circulates in the blood associated with lipoproteins. TFPI directly inhibits factor Xa by binding to the enzyme near its active site. This factor Xa-TFPI complex then inhibits the factor Vlla-tissue factor complex. 

Four naturally occurring thrombin inhibitors exist in normal plasma. The most important is antithrombin III (often called simply antithrombin), which contributes approximately 75% of the antithrombin activity. Antithrombin III can also inhibit the activities of factors IXa, Xa, XIa, Xlla, and Vila complexed with tissue factor. a2-Macroglobulin contributes most of the remainder of the antithrombin activity, with heparin cofactor II and aj-antitrypsin acting as minor inhibitors under physiologic conditions. 

Broze GJ Tissue factor pathway inhibitor and the revised theory of coagulation. Annu Rev Med 1995 46 103. 

LMWHs are formed by various methods of fractionation or depolymerization of polymeric heparin (Table 7.1). Although they are enzymatically derived from UFH, they have a different site of achon and can be administered subcutaneously. LMWHs exert their anhcoagulant effect by inhibiting factor Xa and augmenting tissue-factor-pathway inhibitor, but minimally affect thrombin or factor Ila (Figs. 7.1 and 7.2)." Thus, the PTT, a measure of antithrombin (anh-factor Ila) achvity, is not used to measure the achvity of LMWHs. 

FIGURE 7-4. Coagulation cascade. AT, antithrombin HCII, heparin cofactor II TFPI, tissue factor pathway inhibitor. (Reproduced from Haines ST, Zeolla M, Witt DM. Venous thromboembolism. In ... 

HCII heparin co-factor II TFPI tissue factor pathway inhibitor... 

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