Factor VII-Activating Protease: Hemostatic Protein or Immune Regulator?

Area of Science:

• Biochemistry
• Vascular Biology
• Coagulation Cascade

Background:

• Factor VII (FVII)-activating protease (FSAP) is a plasma serine protease.
• Initially linked to FVII activation and fibrinolysis, recent research questions these roles.
• Emerging evidence suggests FSAP's procoagulant activity via tissue factor pathway inhibitor cleavage and diverse substrate interactions.

Purpose of the Study:

• To review the biochemical properties of FSAP.
• To discuss the regulation of FSAP activation.
• To examine FSAP's role in vascular and inflammatory diseases.

Main Methods:

• Literature review of biochemical and animal studies.
• Analysis of FSAP substrate identification.
• Investigation of FSAP's role in disease pathogenesis.

Main Results:

• FSAP exhibits diverse substrate interactions, including growth factors, histones, and high-molecular-weight kininogen.
• FSAP can induce DNA release from dead cells.
• Animal studies indicate FSAP involvement in arteriosclerosis, vascular integrity, and coagulation regulation.

Conclusions:

• FSAP's function extends beyond initial descriptions, with significant roles in coagulation and inflammation.
• Understanding FSAP activation and regulation is crucial due to its complexity and disease relevance.
• FSAP is implicated in vascular diseases and acute systemic inflammatory conditions like sepsis.