The role of factor VIII in the activation of human blood coagulation factor X by activated factor IX.

The role of factor VIII in the activation of human factor X by factor IXa, Ca2+ and phospholipid has been investigated. Factor VIII stimulated the factor Xa formation after activation by factor Xa or thrombin; the activity of thrombin-activated factor VIII was about 4-fold that of factor Xa-activated factor VIII. The isolated procoagulant moiety of the factor VIII complex behaved identically to the complete complex, whereas the von Willebrand factor moiety did not participate in the factor Xa formation. Thrombin-activated factor VIII complex (factor VIIIa) was used to study the effect of factor VIIIa in kinetic experiments. The results revealed a complex kinetic behaviour, including substrate inhibition and non-linearity of the reaction rate with the enzyme concentration. Using previously obtained insight into the kinetics of factor X activation in the absence of factor VIII, the results were found to support the hypothesis that factor VIIIa participates in the factor Xa formation in a complex with phospholipid-bound factor IXa; the formation of the factor VIIIa-factor IXa complex then increases the catalytic efficiency of the factor IXa by 500-fold.