Protein C (PC) is a vitamin K-dependent glycoprotein produced in the liver. The concentration of PC in plasma is ~4ug/ml (~60nM). A deficiency of Protein C (quantitative or qualitative) is a risk factor for vascular thrombosis. Protein C is expressed as a two-chain molecule with a molecular weight of 62kD. The light chain (21kD) of PC consists of two EGF-like domains and an amino-terminal domain containing one hydroxyaspartic acid and 11g-carboxyglutamic acid (gla) residues. These residues allow PC to bind to membranes that contain acidic phospholipids in a calcium dependent manner. The heavy chain of PC (41kD) consists of the catalytic domain and an activation peptide. Activation of Protein C results from cleavage at residue Arg12 in the heavy chain by a complex of thrombin and a cell surface cofactor thrombomodulin. The activation of PC is associated with the release of a small activation peptide (2-3kD, called Protein C peptide, or PCP) from the N-terminal of the heavy chain. Activated Protein C (APC) is a serine protease with anticoagulant activity. APC, in complex with a phospholipid membrane, calcium and the Protein S cofactor, exhibits anticoagulant activity through the proteolytic inactivation of coagulation cofactors Va and VIIIa. The primary inhibitor of APC activity in plasma is Protein C Inhibitor (PCI, also called Plasminogen Activator Inhibitor-3, PAI-3) and to a lesser extent by alpha A1antitrypsin and alpha 2macroglobulin. The inhibitory activity of PCI is stimulated approximately 10 fold by heparin.

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