Alternate functions of physiological anticoagulants

Area of Science:

• Physiology
• Hematology
• Pharmacology

Background:

• Anticoagulant proteins, including antithrombin (AT), protein C (PC), protein S (PS), and tissue factor pathway inhibitor (TFPI), are crucial regulators of hemostasis.
• These proteins possess anticoagulant activities and exert alternative physiological functions impacting various diseases beyond thrombosis and bleeding.
• Understanding these multifaceted roles is key to developing novel therapeutic strategies.

Purpose of the Study:

• To review recent (2018-2025) literature on the alternative physiological functions of AT, PC, PS, and TFPI in clinical disease.
• To explore the therapeutic applications of these anticoagulants in diverse medical fields.
• To highlight emerging therapeutic avenues based on the non-hemostatic roles of these proteins.

Main Methods:

• Comprehensive literature search of PubMed for articles published between 2018 and early 2025.
• Focused selection of studies investigating alternative functions of AT, PC, PS, and TFPI in various clinical disease categories.
• Categorization of selected therapeutic applications including cancer, cardiovascular disease, pregnancy health, inflammation, infection, stroke, and more.

Main Results:

• Identified significant implications of AT, PC, PS, and TFPI functions beyond anticoagulation.
• Documented emerging therapeutic applications in oncology, cardiovascular medicine, neurology, and infectious diseases.
• Highlighted novel interactions with endothelial cells and platelets, and roles in blood-brain barrier protection.

Conclusions:

• The diverse physiological roles of AT, PC, PS, and TFPI offer promising therapeutic potential for a wide range of human diseases.
• Further research into these alternative functions can unlock novel treatment strategies.
• These findings underscore the importance of considering anticoagulants for non-thrombotic conditions.