Protein C

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Blood Coagulation and Protein C Pathways.jpg
Blood Coagulation (Thrombin) Pathway, and Protein C Pathway. John H. Griffin PhD., TSRI
protein C
Symbol PROC
Entrez 5624
HUGO 9451
OMIM 176860
RefSeq NM_000312
UniProt P04070
Other data
Locus Chr. 2 q13-q21

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Protein C is a major physiological anticoagulant. It is a vitamin K-dependent serine protease enzyme (EC that is activated by thrombin into activated protein C (APC). The activated form (with protein S as a cofactor) degrades Factor Va and Factor VIIIa. It should not be confused with C peptide or c-reactive protein or protein kinase C.

The protein C pathway’s key enzyme, activated protein C, provides physiologic antithrombotic activity and exhibits both anti-inflammatory and anti-apoptotic activities. Its actions are related to development of thrombosis and ischemic stroke. The protein C pathway of the coagulation of the blood involves the influences of lipids and lipoproteins and the study of the strong epidemiologic association between hyperlipidemia and hypercoagulability.[1]

See: detailed diagram of Blood Coagulation (Thrombin) and Protein C Pathways

Role in disease

Protein C deficiency is a rare genetic disorder that predisposes to venous thrombosis and habitual abortion. If homozygous, this presents with a form of disseminated intravascular coagulation in newborns termed purpura fulminans; it is treated by replacing the defective protein C.

Activated protein C resistance is the inability of protein C to cleave factors V and/or VIII. This may be hereditary or acquired. The best known and most common hereditary form is Factor V Leiden. Acquired forms occur in the presence of elevated Factor VIII concentrations.

Warfarin necrosis is acquired protein C deficiency due to treatment with the vitamin K inhibitor anticoagulant warfarin. In initial stages of action, inhibition of protein C may be stronger than inhibition of the vitamin K-dependent coagulation factors (II, VII, IX and X), leading to paradoxical activation of coagulation and necrosis of skin areas.

HDL and the effects of activated protein C (APC) on cells is very important.[2]

The Protein C Anticoagulant Pathway: Thrombin escaping from a site of vascular injury binds to its receptor thrombomodulin (TM) on the intact cell surface. As a result, thrombin loses its procoagulant properties and instead becomes a potent activator of protein C. Activated protein C (APC) functions as a circulating anticoagulant, which specifically degrades and inactivates the phospholipid-bound factors Va and VIIIa. This effectively down-regulates the coagulation cascade and limits clot formation to sites of vascular injury. T = Thrombin, PC= Protein C, Activated Protein C= APC, PS= Protein S[3]


Drotrecogin alpha (activated) is recombinant activated protein C from Ely Lilly Co, USA. It is used in the treatment of severe sepsis, septic shock and disseminated intravascular coagulation.


The PROC gene is located on the second chromosome (2q13-q14).

See also


  1. Thrombosis, Blood Coagulation and the Antithrombotic Protein C Pathway - John H. Griffin, TSRI
  2. Blood review by Mosnier, Zlokovic and Griffin 2006 ePub
  3. Activated protein C resistance

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| group5 = Clinical Trials Involving Protein C | list5 = Ongoing Trials on Protein C at Clinical Trials.govTrial results on Protein CClinical Trials on Protein C at Google

| group6 = Guidelines / Policies / Government Resources (FDA/CDC) Regarding Protein C | list6 = US National Guidelines Clearinghouse on Protein CNICE Guidance on Protein CNHS PRODIGY GuidanceFDA on Protein CCDC on Protein C

| group7 = Textbook Information on Protein C | list7 = Books and Textbook Information on Protein C

| group8 = Pharmacology Resources on Protein C | list8 = AND (Dose)}} Dosing of Protein CAND (drug interactions)}} Drug interactions with Protein CAND (side effects)}} Side effects of Protein CAND (Allergy)}} Allergic reactions to Protein CAND (overdose)}} Overdose information on Protein CAND (carcinogenicity)}} Carcinogenicity information on Protein CAND (pregnancy)}} Protein C in pregnancyAND (pharmacokinetics)}} Pharmacokinetics of Protein C

| group9 = Genetics, Pharmacogenomics, and Proteinomics of Protein C | list9 = AND (pharmacogenomics)}} Genetics of Protein CAND (pharmacogenomics)}} Pharmacogenomics of Protein CAND (proteomics)}} Proteomics of Protein C

| group10 = Newstories on Protein C | list10 = Protein C in the newsBe alerted to news on Protein CNews trends on Protein C</small>

| group11 = Commentary on Protein C | list11 = Blogs on Protein C

| group12 = Patient Resources on Protein C | list12 = Patient resources on Protein CDiscussion groups on Protein CPatient Handouts on Protein CDirections to Hospitals Treating Protein CRisk calculators and risk factors for Protein C

| group13 = Healthcare Provider Resources on Protein C | list13 = Symptoms of Protein CCauses & Risk Factors for Protein CDiagnostic studies for Protein CTreatment of Protein C

| group14 = Continuing Medical Education (CME) Programs on Protein C | list14 = CME Programs on Protein C

| group15 = International Resources on Protein C | list15 = Protein C en EspanolProtein C en Francais

| group16 = Business Resources on Protein C | list16 = Protein C in the MarketplacePatents on Protein C

| group17 = Informatics Resources on Protein C | list17 = List of terms related to Protein C

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