Although it is not enzymatically active, it is structurally related to several
serine proteases of the coagulation cascade:
Factors VII,
IX,
X and
Protein C. The
carboxyglutamate residues (which require Vitamin K) bind Protein Z to
phospholipid surfaces. The main role of Protein Z appears to be the degradation of
Factor Xa. This is done by
Protein Z-related protease inhibitor (ZPI), but the reaction is accelerated 1000-fold by the presence of Protein Z. Oddly, ZPI also degrades
Factor XI, but this reaction does not require the presence of Protein Z. ZPI activated by Protein Z does not appear to happen because of its conformation, but proximity to each other. When Protein Z in bound to ZPI, it will bind to the same phospholipid surface as Factor Xa. This is what promotes the inhibition of Factor Xa. In some studies, deficiency states have been associated with a propensity to
thrombosis. Others, however, link it to
bleeding tendency; there is no clear explanation for this, as it acts physiologically as an inhibitor, and deficiency would logically have led to a predisposition for
thrombosis. == Genetics ==