Recombinant Nematode Anticoagulant Protein c2 and Other Inhibitors Targeting Blood Coagulation Factor VIIa/tissue Factor

J Intern Med. 2003 Oct;254(4):313-21. doi: 10.1046/j.1365-2796.2003.01224.x.


Originally isolated from a haematophagous hookworm, recombinant nematode anticoagulant protein c2 (rNAPc2) is an 85-amino acid protein with potent anticoagulant properties. Unlike conventional anticoagulants that attenuate blood coagulation via inhibition of thrombin or activated factor X (FXa) at the downstream portion of the cascade, rNAPc2 is a potent inhibitor of the activated factor VII/tissue factor complex (FVIIa/TF), the key physiological initiator of blood coagulation. Its mechanism of action requires prerequisite binding to circulating FXa or zymogen factor X (FX) to form a binary complex prior to its interaction and inhibition of membrane-bound FVIIa/TF. The binding of rNAPc2 to FX results in an elimination half-life of longer than 50 h following either subcutaneous or intravenous administration. Recombinant NAPc2, like other inhibitors of FVIIa/TF including tissue factor pathway inhibitor (TFPI) and active site-blocked FVIIa (ASIS, FFR-rFVIIa or FVIIai), may have a promising role in the prevention and treatment of venous and arterial thrombosis, as well as potential efficacy in the management of disseminated intravascular coagulopathies because of their potent and selective inhibition of FVIIa/TF.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anticoagulants / therapeutic use*
  • Blood Coagulation / drug effects
  • Factor VIIa / antagonists & inhibitors*
  • Factor X / metabolism
  • Factor Xa / metabolism
  • Helminth Proteins / therapeutic use*
  • Humans
  • Recombinant Proteins / therapeutic use
  • Thromboplastin / metabolism
  • Thrombosis / prevention & control*
  • Venous Thrombosis / prevention & control


  • Anticoagulants
  • Helminth Proteins
  • Recombinant Proteins
  • anti-coagulant protein C2, Ancylostoma caninum
  • Factor X
  • Thromboplastin
  • Factor VIIa
  • Factor Xa