Tissue factor pathway inhibitor: Regulator of the tissue factor pathway of coagulation and a future antithrombotic agent?

Abstract

Tissue factor pathway inhibitor (TFPI) is a recently 'rediscovered' inhibitor of tissue factor mediated coagulation that has a central role in the modern hypothesis of coagulation. The regulatory role of this inhibitor has redefined the classical extrinsic and intrinsic pathways of coagulation and helps to explain why haemophiliacs bleed. Comprehensive investigations have been performed during the last 15 years to elucidate the structure, distribution, function and physiological characteristics of TFPI. More recent work has focused on the therapeutic potential of TFPI as an antithrombotic agent. Augmentation of TFPI levels may provide treatment for thrombotic disorders such as disseminated intravascular coagulation and deep vein thrombosis. Full length and truncated forms of TFPI molecules are also being considered as antithrombotic agents. These have been used in a number of animal models with initial results demonstrating the alleviation of thrombotic tendencies. Trials are currently ongoing.