Studies on Precursor Proteins PIVKA-II, -IX, and -X in the Plasma of Patients with Ηemorrhagic Disease of the Newborn’

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Abstract
Factors II, IX, and X in the plasmas of 10 patients with ‘hemorrhagic disease of the newborn’ were investigated by means of electroimmunoassay and crossed immunoelectrophoresis (CIE). The biological activity was within 4.2–30 U/dl for factor II, 5.1–20 U/dl for factor IX, and 5.2–24 U/dl for factor X, whereas the immunological antigen was within 33–58, 25–50, and 35–60 U/dl, respectively. Thus, for all factors, 1.7 times more antigen than activity was present. The CIE pattern of factors II and IX in the presence of Ca++ ions clearly showed a biphasic precipitin arc, and in the absence of Ca++ ions, only one precipitin arc was observed. These results implied the presence of precursor proteins PIVKA-II and -IX in the plasma. However, even in the presence of Ca++ ions the CIE pattern of factor X antigen in the patient plasmas only showed a single precipitin arc with a slightly faster than normal electrophoretic mobility. PIVKA-II, -IX, and the abnormal factor X antigen (PIVKA-X) disappeared within 24 h after the patients were treated with vitamin K.