Factor VII

Factor VII (, blood-coagulation factor VIIa, activated blood coagulation factor VII, formerly known as proconvertin) is one of the is_associated_with::proteins that causes blood to clot in the coagulation cascade. It is an is_associated_with::enzyme of the is_associated_with::serine protease class. A recombinant form of human factor VIIa (is_associated_with::eptacog alfa [activated], NovoSeven) has U.S. Food and Drug Administration approval for uncontrolled bleeding in hemophilia patients. It is sometimes used unlicensed in severe uncontrollable bleeding, although there have been safety concerns. A is_associated_with::biosimilar form of recombinant activated factor VII (AryoSeven) is also available, but does not play any considerable role in the market.

Physiology
The main role of factor VII (FVII) is to initiate the process of coagulation in conjunction with is_associated_with::tissue factor (TF/factor III). Tissue factor is found on the outside of blood vessels - normally not exposed to the bloodstream. Upon vessel injury, tissue factor is exposed to the blood and circulating factor VII. Once bound to TF, FVII is activated to FVIIa by different proteases, among which are is_associated_with::thrombin (factor IIa), factor Xa, IXa, XIIa, and the FVIIa-TF complex itself. The complex of factor VIIa with TF catalyzes the conversion of factor IX and factor X into the active proteases, factor IXa and factor Xa, respectively.

The action of the factor is impeded by is_associated_with::tissue factor pathway inhibitor (TFPI), which is released almost immediately after initiation of coagulation. Factor VII is is_associated_with::vitamin K dependent; it is produced in the is_associated_with::liver. Use of is_associated_with::warfarin or similar is_associated_with::anticoagulants decreases hepatic synthesis of FVII.

Genetics
The is_associated_with::gene for factor VII is located on is_associated_with::chromosome 13 (13q34).

Role in disease
Deficiency is rare (congenital proconvertin deficiency) and inherits recessively. Factor VII deficiency presents as a hemophilia-like bleeding disorder. It is treated with recombinant factor VIIa (NovoSeven or is_associated_with::AryoSeven).

Medical uses
is_associated_with::Recombinant factor VIIa, marketed under the trade names AryoSeven and NovoSeven, is used for people with is_associated_with::hemophilia (with is_associated_with::Factor VIII or IX deficiency) who have developed inhibitors against replacement coagulation factor.

It has also been used in the setting of uncontrollable hemorrhage, but its role in this setting is controversial with insufficient evidence to support its use outside of clinical trials. The first report of its use in hemorrhage was in an is_associated_with::Israeli soldier with uncontrollable bleeding in 1999. Risks of its use include an increase in arterial thrombosis.

Recombinant human factor VII while initially looking promising in is_associated_with::intracerebral hemorrhage failed to show benefit following further study and this is no longer recommended.

Interactions
Factor VII has been shown to interact with is_associated_with::tissue factor.