Gene Symbol: PROZ
Description: protein Z, vitamin K dependent plasma glycoprotein
Alias: vitamin K-dependent protein Z, vitamin K-dependent protein Z precursor variant 1
Species: human
Products:     PROZ

Top Publications

  1. Fujimaki K, Yamazaki T, Taniwaki M, Ichinose A. The gene for human protein Z is localized to chromosome 13 at band q34 and is coded by eight regular exons and one alternative exon. Biochemistry. 1998;37:6838-46 pubmed
    ..These genes may have evolved via duplication of an ancestral gene at this locus. ..
  2. Gris J, Amadio C, Mercier E, Lavigne Lissalde G, Dechaud H, Hoffet M, et al. Anti-protein Z antibodies in women with pathologic pregnancies. Blood. 2003;101:4850-2 pubmed
    ..In women, enhanced immune-complex formation with protein Z may play a role in unexplained embryo losses and, from the 10th week of gestation, may favor hypercoagulability in the maternal placenta side. ..
  3. Vossen C, Hasstedt S, Demers C, Rosendaal F, Bovill E. Linkage analysis for three coagulation factors clustering on chromosome 13q34: factor VII, factor X and protein Z. J Thromb Haemost. 2007;5:1325-7 pubmed
  4. Eroglu A, Ozturk A, Cam R, Akar N. Intron F G79A polymorphism of the protein Z gene in cancer patients with and without thrombosis. J Thromb Thrombolysis. 2009;27:204-6 pubmed publisher
    ..Intron F G79A polymorphism of PZ gene does not contribute to meaningful diagnostic investigation of thrombophilia in cancer patients. ..
  5. Vasse M. Protein Z, a protein seeking a pathology. Thromb Haemost. 2008;100:548-56 pubmed
    ..This review analyzes the different studies so far published and discusses the various results obtained in order to understand whether or not protein Z deficiency could be considered as an arterial ischemic risk factor. ..
  6. Ichinose A, Takeya H, Espling E, Iwanaga S, Kisiel W, Davie E. Amino acid sequence of human protein Z, a vitamin K-dependent plasma glycoprotein. Biochem Biophys Res Commun. 1990;172:1139-44 pubmed
    ..Human protein Z, however, contains an Asp instead of Ser and a Lys instead of His in the catalytic triad of the active site. ..
  7. Sejima H, Hayashi T, Deyashiki Y, Nishioka J, Suzuki K. Primary structure of vitamin K-dependent human protein Z. Biochem Biophys Res Commun. 1990;171:661-8 pubmed
    ..Human protein Z was composed of an NH2-terminal domain rich in gamma-carboxyglutamic acids, two epidermal growth factor-like domains and a COOH-terminal serine protease-like domain as was bovine protein Z. ..
  8. Broze G, Miletich J. Human Protein Z. J Clin Invest. 1984;73:933-8 pubmed
    ..Neither Protein Z nor its cleavage products, which were obtained by treatment of Protein Z with thrombin or plasmin, incorporated [3H]diisopropyl fluorophosphate. The physiological function of Protein Z remains unknown. ..
  9. Sierko E, Wojtukiewicz M, Zimnoch L, Ostrowska Cichocka K, Tokajuk P, Ramlau R, et al. Protein Z/protein Z-dependent protease inhibitor system in human non-small-cell lung cancer tissue. Thromb Res. 2012;129:e92-6 pubmed publisher
    ..The presence of F1+2 and fibrin, along with a disproportional expression of ZPI and PZ, might point to impaired function of the coagulation inhibitory system in NSCLC tissue. ..

More Information


  1. Galar M, Piszcz J, Bolkun L, Szumowska A, Kloczko J. Protein Z concentrations in patients with acute leukemia. Clin Appl Thromb Hemost. 2012;18:542-5 pubmed publisher
    ..01). There was no such correlation in ALL group. The results suggest that PZ can be a cofactor associated with an increased bleeding tendency in patients with AML. ..
  2. Sierko E, Wojtukiewicz M, Zimnoch L, Tokajuk P, Ostrowska Cichocka K, Kisiel W. Co-localization of Protein Z, Protein Z-Dependent protease inhibitor and coagulation factor X in human colon cancer tissue: implications for coagulation regulation on tumor cells. Thromb Res. 2012;129:e112-8 pubmed publisher
    ..However, the presence of F1+2 and fibrin at the colon cancer site also suggests that the regulation of FXa by the PZ/ZPI complex at this site is incomplete. ..
  3. Neumann O, Kesselmeier M, Geffers R, Pellegrino R, Radlwimmer B, Hoffmann K, et al. Methylome analysis and integrative profiling of human HCCs identify novel protumorigenic factors. Hepatology. 2012;56:1817-27 pubmed publisher
    ..The present study illustrates that vertical integration of methylation data with high-resolution genomic and transcriptomic data facilitates the identification of new tumor-suppressor gene candidates in human HCC. ..
  4. Xu Y, Liu F, Chen S, Wu J, Hu Y, Zhu B, et al. In vivo evolution of drug-resistant Mycobacterium tuberculosis in patients during long-term treatment. BMC Genomics. 2018;19:640 pubmed publisher
    ..mutations at sites of known drug targets, while some contained mutations in uncertain drug targets including folC, proZ, and pyrG...
  5. Erez O, Hoppensteadt D, Romero R, Espinoza J, Goncalves L, Nien J, et al. Preeclampsia is associated with low concentrations of protein Z. J Matern Fetal Neonatal Med. 2007;20:661-7 pubmed
  6. Iwanaga S, Nishimura H, Kawabata S, Kisiel W, Hase S, Ikenaka T. A new trisaccharide sugar chain linked to a serine residue in the first EGF-like domain of clotting factors VII and IX and protein Z. Adv Exp Med Biol. 1990;281:121-31 pubmed
    ..The presence of the unique trisaccharide structure in factors VII, IX and protein Z leads us to anticipate its biological role in the tissue factor pathway. ..
  7. Salloum Asfar S, Arroyo A, Teruel Montoya R, García Barberá N, Roldan V, Vicente V, et al. MiRNA-Based Regulation of Hemostatic Factors through Hepatic Nuclear Factor-4 Alpha. PLoS ONE. 2016;11:e0154751 pubmed publisher
    ..with miR-24 and miR-34a in HepG2 cells decreased not only HNF4A but also F10, F12, SERPINC1, PROS1, PROC, and PROZ transcripts levels...
  8. Kloek A, Khan H, Valls Seron M, Jongejan A, Zwinderman A, Baas F, et al. Variation in coagulation and fibrinolysis genes evaluated for their contribution to cerebrovascular complications in adults with bacterial meningitis in the Netherlands. J Infect. 2018;77:54-59 pubmed publisher
    ..We identified the functional variant rs494860 in the protein Z (PROZ) gene as our strongest association with occurrence of cerebral infarction (odds ratio (OR) 0...
  9. Fedi S, Sofi F, Brogi D, Tellini I, Cesari F, Sestini I, et al. Low protein Z plasma levels are independently associated with acute coronary syndromes. Thromb Haemost. 2003;90:1173-8 pubmed
    ..The contemporary presence of low PZ levels and smoking habit leads to an increased risk of ACS (OR=9.5; 99%CI 2.4-37.2; p < 0.0001). In conclusion, our results suggest a possible role of PZ in the occurrence of arterial thrombosis. ..
  10. Vasse M, Denoyelle C, Guegan Massardier E, Legrand E, Borg J, Lenormand B, et al. [Protein Z: a new regulator of coagulation in arterial vessels?]. Ann Pharm Fr. 2004;62:316-22 pubmed
    ..This review analyzes the different studies so far published and discusses the different results obtained in order to understand whether or not protein Z deficiency could be considered as an arterial ischemic risk factor. ..
  11. Heeb M, Paganini Hill A, Griffin J, Fisher M. Low protein Z levels and risk of ischemic stroke: differences by diabetic status and gender. Blood Cells Mol Dis. 2002;29:139-44 pubmed
    ..015). Protein Z is suggested to be a physiologic downregulator of blood coagulation and low protein Z levels are associated with increased risk of ischemic stroke, particularly in males and in the absence of diabetes. ..
  12. Cesari F, Fatini C, Sticchi E, Fedi S, Abbate R, Gensini G, et al. Protein Z gene polymorphisms (intron F 79 G>A; -13 A>G) are not associated with acute coronary syndromes. Thromb Haemost. 2006;96:98-9 pubmed
  13. Nien J, Romero R, Hoppensteadt D, Erez O, Espinoza J, Soto E, et al. Pyelonephritis during pregnancy: a cause for an acquired deficiency of protein Z. J Matern Fetal Neonatal Med. 2008;21:629-37 pubmed publisher
    ..The median maternal plasma protein Z concentration was significantly lower in patients with pyelonephritis during pregnancy than in patients with normal pregnancies. ..
  14. Lichy C, Dong Si T, Reuner K, Genius J, Rickmann H, Hampe T, et al. Risk of cerebral venous thrombosis and novel gene polymorphisms of the coagulation and fibrinolytic systems. J Neurol. 2006;253:316-20 pubmed
    ..Furthermore, a protective role in juvenile stroke was shown for a SNP of the vitamin K dependent protein Z (PZ Intron F G79A) which is linked with low PZ levels...
  15. Staton J, Sayer M, Hankey G, Cole V, Thom J, Eikelboom J. Protein Z gene polymorphisms, protein Z concentrations, and ischemic stroke. Stroke. 2005;36:1123-7 pubmed
  16. McQuillan A, Eikelboom J, Hankey G, Baker R, Thom J, Staton J, et al. Protein Z in ischemic stroke and its etiologic subtypes. Stroke. 2003;34:2415-9 pubmed
    ..Further studies are required to elucidate whether protein Z has a causative or prognostic role in acute arterial thrombosis. ..
  17. Huang X, Dementiev A, Olson S, Gettins P. Basis for the specificity and activation of the serpin protein Z-dependent proteinase inhibitor (ZPI) as an inhibitor of membrane-associated factor Xa. J Biol Chem. 2010;285:20399-409 pubmed publisher
  18. Hogg P, Stenflo J. Interaction of human protein Z with thrombin: evaluation of the species difference in the interaction between bovine and human protein Z and thrombin. Biochem Biophys Res Commun. 1991;178:801-7 pubmed
    ..The data suggest that the species difference in the interaction between protein Z and thrombin can be explained by a difference in the COOH-terminal region of bovine protein Z versus human protein Z. ..
  19. Blyth E, Favaloro E, Harris D, Kairaitis L. Protein Z is reduced in chronic kidney disease and not elevated in patients on haemodialysis. Blood Coagul Fibrinolysis. 2008;19:23-5 pubmed publisher
    ..This finding is in contradiction to a previous report which found PZ to be elevated in patients on haemodialysis. ..
  20. Pereza N, Ostojic S, Kapovic M, Peterlin B. Systematic review and meta-analysis of genetic association studies in idiopathic recurrent spontaneous abortion. Fertil Steril. 2017;107:150-159.e2 pubmed publisher genes involved in immune response (IFNG, IL10, KIR2DS2, KIR2DS3, KIR2DS4, MBL, TNF), coagulation (F2, F5, PAI-1, PROZ), metabolism (GSTT1, MTHFR), and angiogenesis (NOS3, VEGFA). However, ORs were modest (0.51-2...
  21. Le Cam Duchez V, Soria C, Dit Sollier C, Borg J, Coudert M, Montalescot G, et al. Rare genotypes of protein Z gene are a risk factor for premature myocardial infarction but not protein Z plasma level. Thromb Haemost. 2009;102:131-6 pubmed publisher
    ..In conclusion, PZ plasma level is not a key player in the pathophysiology of premature coronary artery disease. But, rare genotypes of PZ gene were found to be associated with premature CAD. ..
  22. Wadelius M, Chen L, Eriksson N, Bumpstead S, Ghori J, Wadelius C, et al. Association of warfarin dose with genes involved in its action and metabolism. Hum Genet. 2007;121:23-34 pubmed
    ..PROC, APOE, EPHX1, CALU, GGCX and ORM1-ORM2 and haplotypes of VKORC1, CYP2C9, CYP2C8, CYP2C19, PROC, F7, GGCX, PROZ, F9, NR1I2 and ORM1-ORM2 were associated with dose (P < 0.05)...
  23. Bolkun L, Galar M, Piszcz J, Lemancewicz D, Kloczko J. Plasma concentration of protein Z and protein Z-dependent protease inhibitor in patients with haemophilia A. Thromb Res. 2013;131:e110-3 pubmed publisher
    ..78, p=0.002). In conclusion, despite the fact that FVIII deficiency is undoubtedly the main mechanism of bleeding in haemophilia A patients, the activity of PZ/ZPI complex may play some modulating role in the matter. ..
  24. Qureshi S, Lu Q, Manithody C, Yang L, Rezaie A. Characterization of the protein Z-dependent protease inhibitor interactive-sites of protein Z. Biochim Biophys Acta. 2014;1844:1631-7 pubmed publisher
    ..Insight is provided into mechanisms through which specificity of ZPI-PZ-FXa complex formation is determined. ..
  25. Mahdi N, Abu Hijleh T, Abu Hijleh F, Sater M, Al Ola K, Almawi W. Protein Z polymorphisms associated with vaso-occlusive crisis in young sickle cell disease patients. Ann Hematol. 2012;91:1215-20 pubmed publisher
    ..Of these, only AGTG (P(c)=0.001) and GGTG (P(c)=0.018) remained significant after applying the Bonferroni correction. In conclusion, specific PZ variants and haplotypes are significantly associated with SCD VOC. ..
  26. Zhang L, Segal A, Leifer D, Silverstein R, Gerber L, Devereux R, et al. Circulating protein Z concentration, PROZ variants, and unexplained cerebral infarction in young and middle-aged adults. Thromb Haemost. 2017;117:149-157 pubmed publisher
    ..We investigated PZ levels and PROZ variants in a multi-ethnic case-control study of unexplained stroke in participants aged 18 to 64...
  27. El Hamid S, El Khayat W. Relationship of the protein Z intron F G79A and IL6 C634G gene polymorphisms with the risk of recurrent pregnancy loss in Egyptian women. J Investig Med. 2011;59:655-60 pubmed publisher
  28. Sipahi T, Kuybulu A, Ozturk A, Akar N. Protein Z G79A polymorphism in patients with severe sepsis. Clin Appl Thromb Hemost. 2010;16:334-6 pubmed publisher
    ..They concluded that the frequency of intron F G79A polymorphism of protein Z gene was higher in patients than controls, and carrying 79 AA genotype could be a risk factor for severe sepsis and septic shock. ..
  29. Le Cam Duchez V, Barbay V, Bal dit Sollier C, Drouet L, Coudert M, Soria C, et al. Haplotypic or genotypic combinations of three protein Z polymorphisms influence protein Z plasma level. Thromb Haemost. 2009;101:212-4 pubmed
  30. Yousry S, Shahin R, El Refai R. Contribution of protein Z gene single-nucleotide polymorphism to systemic lupus erythematosus in Egyptian patients. Blood Coagul Fibrinolysis. 2016;27:691-5 pubmed publisher
    ..Polymorphisms in the protein Z gene (PROZ) may affect protein Z levels and thus play a role in thrombosis...
  31. Sofi F, Cesari F, Gensini G, Abbate R, Fedi S. Protein Z levels, protein Z G79A polymorphism, and prothrombotic conditions. Stroke. 2005;36:1821; author reply 1821-2 pubmed
  32. Kemkes Matthes B, Nees M, Kühnel G, Matzdorff A, Matthes K. Protein Z influences the prothrombotic phenotype in Factor V Leiden patients. Thromb Res. 2002;106:183-5 pubmed
    ..We here present first studies in humans, indicating that diminution of protein Z in factor V Leiden patients aggravates thromboembolic risk. ..
  33. Sierko E, Wojtukiewicz M, Zimnoch L, Tokajuk P, Kisiel W. Protein Z is present in human breast cancer tissue. Int J Hematol. 2011;93:681-683 pubmed publisher
  34. Yadav D, De T, Nagaraja D, Christopher R. Protein Z G79A polymorphism and puerperal cerebral venous thrombosis. Clin Appl Thromb Hemost. 2015;21:768-71 pubmed publisher
    ..52-2.35; P = .909). There was no significant difference in the clinical features of the patients with and without the polymorphism. We therefore conclude that PZ G79A polymorphism is not a risk factor for puerperal CVT in Indian women. ..
  35. Huang X, Zhou J, Zhou A, Olson S. Thermodynamic and kinetic characterization of the protein Z-dependent protease inhibitor (ZPI)-protein Z interaction reveals an unexpected role for ZPI Lys-239. J Biol Chem. 2015;290:9906-18 pubmed publisher
    ..Together, these results reveal the energetic basis of the ZPI-PZ interaction and suggest an important role for ZPI Lys-239 in PZ catalytic action. ..
  36. Souri M, Koseki Kuno S, Iwata H, Kemkes Matthes B, Ichinose A. A naturally occurring E30Q mutation in the Gla domain of protein Z causes its impaired secretion and subsequent deficiency. Blood. 2005;105:3149-54 pubmed
    ..The IntF79A allele has been reported to be also associated with lowered protein Z levels. ..
  37. Koren Michowitz M, Eting E, Rahimi Levene N, Garach Jehoshua O, Volcheck Y, Kornberg A. Protein Z levels and central retinal vein or artery occlusion. Eur J Haematol. 2005;75:401-5 pubmed
    ..Low protein Z level may be another risk factor for retinal vessel occlusion in patients without traditional risk factors for these disorders. ..
  38. Vasse M. The protein Z/protein Z-dependent protease inhibitor complex. Systemic or local control of coagulation?. Hamostaseologie. 2011;31:155-8, 160-4 pubmed publisher
    ..At this time, the measurement of plasma PZ and ZPI or analysis of their gene polymorphisms should not be performed routinely for the exploration of thrombophilia. ..
  39. Jiang T, Shi L, Wei L, Li X, Yang S, Wang C, et al. Serum amyloid A, protein Z, and C4b-binding protein ? chain as new potential biomarkers for pulmonary tuberculosis. PLoS ONE. 2017;12:e0173304 pubmed publisher
    ..with TB (n = 136) exhibited significantly higher levels of serum amyloid A (SAA), vitamin K-dependent protein Z (PROZ), and C4b-binding protein ? chain (C4BPB) than those in healthy controls (n = 66) (P<0...
  40. Vasse M, Guegan Massardier E, Borg J, Woimant F, Soria C. Frequency of protein Z deficiency in patients with ischaemic stroke. Lancet. 2001;357:933-4 pubmed
    ..We saw no increase in the frequency of protein Z deficiency in 56 patients with venous thrombophilia. However, why protein Z deficiency was only observed in arterial thrombosis remains unknown. ..
  41. Souri M, Iwata H, Zhang W, Ichinose A. Unique secretion mode of human protein Z: its Gla domain is responsible for inefficient, vitamin K-dependent and warfarin-sensitive secretion. Blood. 2009;113:3857-64 pubmed publisher
    ..Thus, it was concluded that the difference observed in secretion patterns of protein Z and factor X was mainly based on the structure of their gamma-carboxyglutamic acid domains. ..
  42. Hogg P, Stenflo J. Interaction of vitamin K-dependent protein Z with thrombin. Consequences for the amidolytic activity of thrombin and the interaction of thrombin with phospholipid vesicles. J Biol Chem. 1991;266:10953-8 pubmed
    ..They also suggest a mechanism whereby thrombin is localized to an injury site by virtue of its interaction with protein Z bound to phospholipid surfaces. ..
  43. Sierko E, Wojtukiewicz M, Zimnoch L, Tokajuk P, Ostrowska Cichocka K, Kisiel W. Protein Z/protein Z-dependent protease inhibitor system in loco in human gastric cancer. Ann Hematol. 2014;93:779-84 pubmed publisher
    ..The co-localization of PZ/ZPI and FX in gastric cancer cells indicates in loco that these proteins may play a role in anticoagulant events at the tumor tissue. ..
  44. Huang X, Liu B, Wei Y, Beyea R, Yan H, Olson S. Lipid oxidation inactivates the anticoagulant function of protein Z-dependent protease inhibitor (ZPI). J Biol Chem. 2017;292:14625-14635 pubmed publisher
    ..We conclude that compromised ZPI anticoagulant function could contribute to thrombus initiation and growth in oxidative stress-induced cardiovascular diseases. ..
  45. Nowak Gottl U, Fröhlich B, Thedieck S, Huge A, Stoll M. Association of the protein Z ATG haplotype with symptomatic nonvascular stroke or thromboembolism in white children: a family-based cohort study. Blood. 2009;113:2336-41 pubmed publisher
    ..4; 95% confidence interval [95% CI] 1.08-1.93). Our results suggest that the ATG haplotype of the PZ gene is a genetic marker for symptomatic TE in white German children. ..
  46. Lee C, Chandrasekaran V, Duke R, Perera L, Pedersen L. A proposed structural model of human protein Z. J Thromb Haemost. 2007;5:1558-61 pubmed
  47. Kaygusuz I, Firatli Tuglular T, Toptas T, Ugurel V, Demir M. Low levels of protein Z are associated with HELLP syndrome and its severity. Clin Appl Thromb Hemost. 2011;17:214-9 pubmed publisher
    ..We calculated 1330 ng/mL as a cutoff value for PZ level to discriminate HELLP syndrome from normal pregnancy. Low PZ levels are associated with the pathobiology of HELLP syndrome. ..
  48. Zeng Y, Zhang L, Hu Z, Yang Q, Ma M, Liu B, et al. Association of protein Z and factor VII gene polymorphisms with risk of cerebral hemorrhage: a case-control and a family-based association study in a Chinese Han population. J Genet. 2016;95:383-8 pubmed
    ..045; Z= -2.015, P = 0.043, respectively). This is a first family-based association study providing genetic evidences that PZ and FVII genes, especially PZ rs2273971 are involved in the development of CH in Han-Chinese families. ..
  49. Yang Q, Kathiresan S, Lin J, Tofler G, O Donnell C. Genome-wide association and linkage analyses of hemostatic factors and hematological phenotypes in the Framingham Heart Study. BMC Med Genet. 2007;8 Suppl 1:S12 pubmed
    ..Further study of additional strongly associated SNPs and linked regions may identify novel variants that influence the inter-individual variability in hemostatic factors and hematological phenotypes. ..
  50. Liu B, Li Y, Luo J, Dai L, Zhao J, Li H, et al. Low protein Z plasma level is a risk factor for acute myocardial infarction in coronary atherosclerosis disease patients. Thromb Res. 2016;148:25-31 pubmed publisher
    ..79; P<0.001 respectively). PZ deficiency is found in AMI patients and could potentially reflect the myocardium injury, local coagulation activation and inflammation response during the acute phase of coronary atherosclerosis disease. ..
  51. Le Cam Duchez V, Barbay V, Soria C, Borg J. [Protein Z, polymorphisms in the protein Z gene and thrombosis]. Rev Med Interne. 2010;31:551-7 pubmed publisher
    ..PZ measurement is not actually considered as a biological marker of thrombophilia. Large prospective studies remain to be done to investigate its possible role in thrombosis. ..
  52. Doat S, Borgel D, François J, Bianchini E, Botton J, Francois D, et al. Unbalance between plasma levels of Protein Z and protein Z-dependent inhibitor in patients with colorectal and pancreatic cancer: a pilot study. Thromb Res. 2014;133:299-300 pubmed publisher
  53. Huang X, Yan Y, Tu Y, Gatti J, Broze G, Zhou A, et al. Structural basis for catalytic activation of protein Z-dependent protease inhibitor (ZPI) by protein Z. Blood. 2012;120:1726-33 pubmed publisher
    ..These findings identify the key determinants of catalytic activation of ZPI by PZ and suggest novel strategies for ameliorating hemophilic states through drugs that disrupt the ZPI-PZ interaction. ..
  54. Kiesewetter H, Radtke H, Jainz A, Schmidt F. [Protein Z deficiency in unexplained affinity to thromboses, bleedings or abortions]. Hamostaseologie. 2012;32 Suppl 1:S95-7 pubmed
    ..7 patients had had an abortion before. Bleeding complications were seen in 4 patients, of which 3 suffered from von Willebrand disease type 1. ..
  55. Al Shaikh F, Sater M, Finan R, Racoubian E, Abu Hijleh T, Mustafa F, et al. Protein Z variants associated with protein Z plasma levels and with risk of idiopathic recurrent miscarriage. Reprod Sci. 2013;20:1062-8 pubmed publisher
    ..These results demonstrate that specific PZSNPs and haplotypes are significantly associated with IRM. ..
  56. Vasse M, Denoyelle C, Legrand E, Vannier J, Soria C. Weak regulation of protein Z biosynthesis by inflammatory cytokines. Thromb Haemost. 2002;87:350-1 pubmed
  57. Ghinoi A, Boiardi L, Atzeni F, Casali B, Farnetti E, Nicoli D, et al. Protein Z G79A and A-13G gene polymorphisms in Italian patients with Behçet's disease. Clin Exp Rheumatol. 2009;27:S23-8 pubmed
    ..Furthermore, these protein Z polymorphisms in BD do not seem to increase the risk of DVT due to factor V Leiden or prothrombin gene G20210A mutations. ..
  58. Broze G, Tu Y. Protein Z and protein Z-dependent protease inhibitor and renal tubules. Thromb Haemost. 2010;103:473-4 pubmed publisher
  59. Quack Loetscher K, Stiller R, Roos M, Zimmermann R. Protein Z in normal pregnancy. Thromb Haemost. 2005;93:706-9 pubmed
    ..The normal increase of protein Z during pregnancy may balance the increase of clotting factors to protect pregnant women from thrombosis. ..
  60. Le Cam Duchez V, Bagan Triquenot A, Barbay V, Mihout B, Borg J. The G79A polymorphism of protein Z gene is an independent risk factor for cerebral venous thrombosis. J Neurol. 2008;255:1521-5 pubmed publisher
    ..The G79A polymorphism of the PZ gene was shown to be a new independent risk factor for cerebral venous thrombosis. Nevertheless, these results have to be confirmed by a prospective study including plasma PZ evaluation. ..
  61. Iman S, el Sahrigy S, Sedki M, Baker S, Marey S. Role of protein Z and protein C in neonates with respiratory distress syndrome in Egypt (experience of one centre). Pak J Biol Sci. 2009;12:1468-73 pubmed
    ..Further studies are recommended to evaluate the role of PTZ on outcome in premature newborns with RDS and to evaluate the relationship between protein PTZ and PTC and other coagulation factors incriminated in the development of RDS. ..
  62. Ozturk M, Ozbalkan Z, Onat A, Ertenli I, Kiraz S, Aytemir K, et al. Decreased protein Z concentrations complicating the hypercoagulable state of Behçet's disease. Clin Appl Thromb Hemost. 2003;9:259-63 pubmed
    ..Furthermore, the tendency of increment in the protein Z with the passage of time may reflect the diminution of the disease activity. ..
  63. Demir H, Yalçindağ F, Ozturk A, Akar N. Intron F G79A polymorphism of the protein Z gene in Turkish Behçet patients. Curr Eye Res. 2012;37:630-2 pubmed publisher
    ..65; 95% CI, 0.3 to 1.4; p = 0.28). Although thrombosis in BD is multifactorial, intron F G79A polymorphism of PZ gene in BD may be one of the factors that contribute to this pathological process. ..
  64. Sofi F, Cesari F, Abbate R, Gensini G, Broze G, Fedi S. A meta-analysis of potential risks of low levels of protein Z for diseases related to vascular thrombosis. Thromb Haemost. 2010;103:749-56 pubmed publisher
    ..18, 95%CI 1.19-4.00; p=0.01). The results of this meta-analysis are consistent with a role for protein Z deficiency in thrombotic diseases, including arterial thrombosis, pregnancy complications and venous thromboembolism. ..
  65. Grandone E, Favuzzi G, De Stefano V, Chinni E, Rossi E, Cappucci F, et al. Protein Z g-42a variant and the risk of pregnancy-related venous thromboembolism in a cohort of Italian patients. Thromb Res. 2009;123:848-50 pubmed publisher
  66. Dossenbach Glaninger A, van Trotsenburg M, Helmer H, Oberkanins C, Hopmeier P. Association of the protein Z intron F G79A gene polymorphism with recurrent pregnancy loss. Fertil Steril. 2008;90:1155-60 pubmed publisher
    ..The isolated presence of the PZ intron F 79A allele as well as the combination with known thrombophilic risk factors was protective against RPL between the 8th and 12th weeks of gestation. ..
  67. van Goor M, Dippel D, Jie K, De Maat M, Koudstaal P, Leebeek F. Low protein Z levels but not the protein Z gene G79A polymorphism are a risk factor for ischemic stroke. Thromb Res. 2008;123:213-8 pubmed publisher
    ..2 (95% CI: 0.7-2.1). No association between the G79A PZ gene polymorphism and the occurrence of stroke was observed. However, low PZ levels are independently associated with an increased risk of ischemic stroke. ..
  68. Caliandro R, Nico G, Tiscia G, Favuzzi G, De Stefano V, Rossi E, et al. Structural analysis of protein Z gene variants in patients with foetal losses. Thromb Haemost. 2013;110:534-42 pubmed publisher
    ..In conclusion, a possible interpretation of effects associated with observed gene variants is provided. The exploration of PZ/PZI interactions seems essential in explaining these effects. ..
  69. Almawi W, Al Shaikh F, Melemedjian O, Almawi A. Protein Z, an anticoagulant protein with expanding role in reproductive biology. Reproduction. 2013;146:R73-80 pubmed publisher
    ..PZ deficiency has also been reported to be constitutional, and a number of variants in the PROZ (PZ) gene and SERPINA10 (ZPI) gene are linked with specific adverse pregnancy complications...
  70. Paidas M, Ku D, Lee M, Manish S, Thurston A, Lockwood C, et al. Protein Z, protein S levels are lower in patients with thrombophilia and subsequent pregnancy complications. J Thromb Haemost. 2005;3:497-501 pubmed
    ..4 +/- 11.8% vs. 38.9 +/- 10.3%, P < 0.05, respectively; and 3rd TRI 27.5 +/- 8.4 vs. 31.2 +/- 7.4, P < 0.025, respectively). We posit that decreased PZ and PS levels are additional risk factors for APO. ..
  71. Sugawara H, Iwata H, Souri M, Ichinose A. Regulation of human protein Z gene expression by liver-enriched transcription factor HNF-4alpha and ubiquitous factor Sp1. J Thromb Haemost. 2007;5:2250-8 pubmed
    ..These findings provide the first step toward understanding the mechanisms of the varying plasma PZ levels in individuals under physiological and pathological conditions. ..
  72. Sofi F, Cesari F, Pratesi G, Cellai A, Pulli R, Pratesi C, et al. Low protein Z levels in patients with peripheral arterial disease. Thromb Haemost. 2007;98:1114-7 pubmed
    ..03). In conclusion, our data shows an association between low protein Z levels and the occurrence of PAD. These findings provide evidence for the role of protein Z in the pathogenesis of the atherosclerotic disease. ..
  73. Topalidou M, Effraimidou S, Farmakiotis D, Papadakis E, Papaioannou G, Korantzis I, et al. Low protein Z levels, but not the intron F G79A polymorphism, are associated with unexplained pregnancy loss. Thromb Res. 2009;124:24-7 pubmed publisher
    ..The present case-control study was designed in order to investigate the association between plasma protein Z (PZ) levels, the intron F G79A polymorphism and unexplained pregnancy loss...
  74. Nishimura H, Kawabata S, Kisiel W, Hase S, Ikenaka T, Takao T, et al. Identification of a disaccharide (Xyl-Glc) and a trisaccharide (Xyl2-Glc) O-glycosidically linked to a serine residue in the first epidermal growth factor-like domain of human factors VII and IX and protein Z and bovine protein Z. J Biol Chem. 1989;264:20320-5 pubmed
    ..Whether these carbohydrate moieties contribute to the biological activities of these proteins is unknown. ..
  75. Gowri V, Mathew M, Gravell D, Alfalahi K, Zakwani I, Ganguly S, et al. Protein Z levels in pregnant Omani women: correlation with pregnancy outcome. J Thromb Thrombolysis. 2011;32:453-8 pubmed publisher
    ..Isolated PZ deficiency alone did not result in an abnormal outcome in this cohort of subjects. ..