Tissue factor exposed at the endothelial cell surface forms a Ca2+-dependent complex with factor VIIa (FVIIa, activated FVII) from the plasma (Butenas S et al. 1994; Sabharwal AK et al. 1995; Banner DW et al. 1996; Bajaj SP et al. 2006; Persson E & Olsen OH 2011; Madsen JJ et al. 2015). FVIIa is allosterically activated by TF, which increases the amidolytic activity of FVIIa by restructuring the active site region (Komiyama Y et al., 1990; Butenas S et al. 1994; Higashi S et al. 1996; Sorensen AB et al. 2019). FVIIa, bound to TF at the endothelial cell surface, catalyzes the formation of activated factor IXa (FIXa) and FXa with high efficiency leading to thrombin generation and fibrin formation (Vadivel K & Bajaj SP 2012).
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