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Genetic, Functional and Therapeutic Aspects of Procoagulant and Anticoagulant Factors (Third Edition)

A special issue of International Journal of Molecular Sciences (ISSN 1422-0067). This special issue belongs to the section "Molecular Pathology, Diagnostics, and Therapeutics".

Deadline for manuscript submissions: 30 September 2026 | Viewed by 1947

Special Issue Editors

Special Issue Information

Dear Colleagues,

This is a continuation of the series on the hot topic of the “Genetic, Functional and Therapeutic Aspects of Procoagulant and Anticoagulant Factors”; our 1st and 2nd editions of Special Issue on this topic received interesting contributions and discussions.

https://www.mdpi.com/journal/ijms/special_issues/Anticoagulant_Factors

https://www.mdpi.com/journal/ijms/special_issues/Pro_Anticoagulant

Normal hemostasis is highly dependent on the balance between procoagulant systems (e.g., platelets and procoagulant factors) and anticoagulant systems (e.g., protein C, protein S and antithrombin). The lack or dysfunction of a major procoagulant factor results in a bleeding disorder (e.g., factor VIII deficiency leading to hemophilia A), whereas a defect in an essential anticoagulant system (e.g., protein C deficiency) leads to a thrombotic disorder. Beyond their function in hemostasis, cell signaling pathways that are induced by procoagulant (e.g., thrombin and FVII) and anticoagulant factors (e.g., APC), mediated by specific receptors, have become the focus of increasing attention, with some of them being explored as promising therapeutic targets.

This Special Issue will focus on the genetic, functional and therapeutic aspects of procoagulant and anticoagulant systems. We invite research studies and reviews on the genetics of bleeding and thrombotic disorders and functional and therapeutic studies of procoagulant and anticoagulant factors, as well as studies that explore their involvement in the crosstalk between hemostasis and inflammation.

Dr. Rima Dardik
Prof. Tami Livnat
Guest Editors

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Keywords

  • procoagulant factors
  • anticoagulant factors
  • hemostasis
  • inflammation
  • genetics
  • therapeutics
  • cell signaling

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Published Papers (3 papers)

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Research

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16 pages, 1076 KB  
Article
A Deletion Variant of Human Factor VIII Displaying Low Immunogenicity in a Murine Model of Hemophilia A
by Erika de Simone Molina, Theri Leica Degaki, Mari Cleide Sogayar and Marcos Angelo Almeida Demasi
Int. J. Mol. Sci. 2025, 26(24), 12093; https://doi.org/10.3390/ijms262412093 - 16 Dec 2025
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Abstract
The therapeutic clotting factor VIII (FVIII) is known for its particular immunogenicity, with nearly 30% of hemophilic patients developing neutralizing antibodies against the infused protein. The root cause of this immunogenicity is still not well understood, but intrinsic factors, such as FVIII byproducts, [...] Read more.
The therapeutic clotting factor VIII (FVIII) is known for its particular immunogenicity, with nearly 30% of hemophilic patients developing neutralizing antibodies against the infused protein. The root cause of this immunogenicity is still not well understood, but intrinsic factors, such as FVIII byproducts, have been linked to the immunological response elicited. Bioengineering of the FVIII molecule has been improving its recombinant (rhFVIII) production in many aspects, mainly enhancing its expression and stability. Assessment of immunogenicity for novel recombinant isoforms is crucial for further development and scaling-up processes, particularly due to the unpredictable antigenic properties and their impact on neutralizing antibody formation. In the present study, we describe a bioengineered human recombinant FVIII (rhFVIII-H6A), which induces lower immunogenicity in a murine model of hemophilia A. The rhFVIII-H6A product is characterized by a B-domain-deleted heavy chain (HCh), with the C-terminal of the B-domain fused to the light chain (BΔ-LCh). Compared to plasma-derived FVIII (pdFVIII) and rhFVIII reference products, treating hemophilic mice with rhFVIII-H6A induced lower levels of anti-FVIII antibody formation, including those with inhibitory neutralizing activity, while no difference was observed in the functional activity of rhFVIII-H6A in reverting the in vivo hemophilia phenotype. In addition, our results indicate that deleting the major part of the B-domain from the HCh might lower the immunogenicity of novel rhFVIII products. Full article
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Review

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18 pages, 1446 KB  
Review
Activated Protein C and the Retina: From Physiology to Therapeutic Potential
by Alon Zahavi, Sarina Levy-Mendelovich, John H. Griffin and Tami Livnat
Int. J. Mol. Sci. 2026, 27(5), 2282; https://doi.org/10.3390/ijms27052282 - 28 Feb 2026
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Abstract
Protein C (PC) and its activated form, activated protein C (APC), are well-established regulators of coagulation and cytoprotection. While their systemic functions are extensively characterized, their physiological roles in the retina have only recently begun to be explored. This gap persists despite the [...] Read more.
Protein C (PC) and its activated form, activated protein C (APC), are well-established regulators of coagulation and cytoprotection. While their systemic functions are extensively characterized, their physiological roles in the retina have only recently begun to be explored. This gap persists despite the observation that congenital PC deficiency is consistently associated with severe ocular complications. Emerging evidence, including the development of a murine model of severe protein C deficiency (SPCD), indicates that APC contributes to retinal integrity and vascular homeostasis under physiological conditions. Beyond its physiological function, APC has shown therapeutic activity in several models of retinal disease. Recent findings from our group further demonstrated that intravenously administered APC and its cytoprotective analog, 3K3A-APC, can cross the blood–retina barrier via the endothelial protein C receptor (EPCR), despite their relatively large molecular weight (~62 kDa), and induce cytoprotective activities in the retina. These findings highlight the translational potential of 3K3A-APC and support its further development as a systemically delivered therapeutic approach for retinal pathologies. This review integrates current knowledge of the molecular biology of the PC/APC pathways with its emerging physiological functions in the retina, and the accumulating preclinical and early clinical evidence that supports its therapeutic relevance. Full article
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29 pages, 1686 KB  
Review
Unmet Needs and Challenges in Cancer-Associated Venous Thromboembolism
by Sanober Nusrat, Sayeed Khan, Kisha Beg and Gary Raskob
Int. J. Mol. Sci. 2026, 27(4), 1756; https://doi.org/10.3390/ijms27041756 - 12 Feb 2026
Viewed by 573
Abstract
Cancer-associated venous thromboembolism (CA-VTE) is a significant complication in oncology, contributing to morbidity, mortality, and increased healthcare utilization. Due to multiple patient- and disease-related factors, patients with cancer are at a markedly elevated risk for VTE, particularly within the first 6 months of [...] Read more.
Cancer-associated venous thromboembolism (CA-VTE) is a significant complication in oncology, contributing to morbidity, mortality, and increased healthcare utilization. Due to multiple patient- and disease-related factors, patients with cancer are at a markedly elevated risk for VTE, particularly within the first 6 months of diagnosis. The aim of this review is to provide an overview of current challenges and unmet needs in CA-VTE prediction, prevention and management. While the Khorana score remains the most widely used risk stratification tool, its limited sensitivity has prompted the development of more refined models such as PROTECHT, CONKO, ONKOTEV, Vienna-CATS, and COMPASS-CAT. These models incorporate additional clinical variables including cancer subtype, systemic therapies, comorbidities, and emerging biomarkers. However important gaps remain, particularly in addressing bleeding risk, underrepresented racial/ethnic groups, and adapting to novel cancer therapeutics. Recent clinical trials (AVERT, CASSINI) have supported the use of direct oral anticoagulants (DOACs) for primary and secondary prophylaxis in select high-risk populations. However, anticoagulation strategies in complex populations, including those with thrombocytopenia, brain tumors, or concurrent antiplatelet therapy, remain areas of active investigation. Future directions include the integration of genomics, proteomics, and machine learning into risk modeling to enable precision medicine approaches. Ongoing clinical trials are testing the promise of safer prophylactic and therapeutic strategies. Personalized risk assessment and treatment of CA-VTE remain essential to improving patient outcomes in oncology. By consolidating existing evidence and identifying key unmet needs, this review seeks to guide more personalized and effective management of CA-VTE. Full article
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