Warfarin and the Biochemistry of the Vitamin K Dependent Proteins

Abstract
The vitamin K-dependent proteins are a diverse group of molecules, all sharing the unique amino acid gamma carboxy glutamic acid (Gla). Gla is produced by the vitamin K-dependent post translational gamma carboxylation of selected glutamic acid residues, a step blocked by warfarin (Fig. 1). Gla-containing proteins have been most thoroughly studied in the blood coagulation system and bone but are found in other tissues such as the kidney. This review will focus on the blood coagulation system but will also touch on other Gla-containing proteins which shed light on common structural and functional features.