Evidence map›Paper›PMID 42020574›Full record

ArticleThe EMBO journal2026

Prothrombinase processivity is conferred by substrate allostery.

Fatma Işık Üstok, Alexandre Faille, Alan J Warren, James A Huntington

Abstract read
In one paragraph

Article in The EMBO journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Fatma Işık Üstok *Cambridge Institute for Medical Research, Department of Haematology, University of Cambridge, The Keith Peters Building, Hills Road, Cambridge, CB2 0XY, United Kingdom.ORCID http://orcid.org/0000-0001-7070-4175
Alexandre Faille *Cambridge Institute for Medical Research, Department of Haematology, University of Cambridge, The Keith Peters Building, Hills Road, Cambridge, CB2 0XY, United Kingdom.
Alan J WarrenCambridge Institute for Medical Research, Department of Haematology, University of Cambridge, The Keith Peters Building, Hills Road, Cambridge, CB2 0XY, United Kingdom.ORCID http://orcid.org/0000-0001-9277-4553
James A HuntingtonCambridge Institute for Medical Research, Department of Haematology, University of Cambridge, The Keith Peters Building, Hills Road, Cambridge, CB2 0XY, United Kingdom. jah52@cam.ac.uk.ORCID http://orcid.org/0000-0003-0076-7204

Funding

British Heart Foundation (BHF) PG/24/11721British Heart Foundation (BHF) RG/16/9/32391Cancer Research UK (CRUK) DRCNPG-Jun24/100002UKRI | Medical Research Council (MRC) UKRI1443
6 · The paper itself

Abstract

The prothrombinase complex, comprised of factor (f) Xa and fVa, converts prothrombin to thrombin through sequential cleavage at two sites in a rapid and processive manner. The molecular basis of prothrombin processing is an enzymatical mystery that to solve requires structural insight into how the substrate and intermediate bind to prothrombinase. Here we present two 3.1 Å cryo-EM structures of prothrombinase bound to prothrombin and to meizothrombin. The prothrombin complex revealed a surprising interaction between the end of the heavy chain of fVa with exosite I of prothrombin, accounting for 70% of the contact interface. Triggering of the zymogen-to-protease conformational change following cleavage at Arg320 alters all domain-domain and fVa interactions observed for prothrombin, and results in a large-scale rearrangement of meizothrombin that presents the second cleavage site (Arg271) for processing. Together, these structures reveal a remarkable enzymatic mechanism that requires the active participation of the substrate itself, and introduces a new paradigm of 'substrate allostery'.

Indexed as

Enzyme PrecursorsProthrombinThrombinThromboplastinAllosteric RegulationAmino Acid SequenceCryoelectron MicroscopyFactor VModels, MolecularProtein BindingProtein Structure, QuaternaryStatic ElectricitySubstrate SpecificityEnzyme PrecursorsFactor VmeizothrombinProthrombinThrombinThromboplastin

Identifiers

PMID42020574
PMCPMC13226733

What OpenQuestion holds

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Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.