Factors IIa, Xa, VIIa, IXa and XIa are all proteolytic enzymes that have a specific role in the coagulation cascade. Factor Xa (FXa) is the most promising one due to its position at the intersection of the intrinsic and extrinsic pathway as well as generating around 1000 thrombin molecules for each Xa molecule which results in a potent anticoagulant effect. FXa is generated from FX by cleavage of a 52 amino acid activation peptide, as the "a" in factor Xa means activated. FXa consists of 254 amino acid catalytic domain and is also linked to a 142 amino acid light chain. The chain contains both GLA domain and two epidermal growth factor domains (EGF like domains).
The active site of FXa is structured to catalyze the cleavage of physiological substrates and cleaves PhePheAsnProArg-ThrPhe and TyrIleAspGlyArg-IleVal in prothrombin. FXa has four so-called pockets which are targets for substrates to bind to factor Xa. These pockets are lined up by different amino acids and Xa inhibitors target these pocket when binding to factor Xa. The two most relevant pockets regarding affinity and selectivity for the Xa inhibitors are S1 and S4.
S1: The S1 pocket is a hydrophobic pocket and contains an aspartic acid residue (Asp-189) which can serve as a recognition site for a basic group. FXa has a residual space in the S1 pocket and is lined by residues Tyr-228, Asp-189 and Ser-195.
S2: The S2 pocket is a small and shallow pocket. It merges with the S4 pocket and has room for small amino acids. Tyr-99 seems to block access to this pocket, so this pocket is not as important as S1 and S4.
S3: The S3 pocket is located on the rim of the S1 pocket and is flat and exposed to the solvent. This pocket is not as important as S1 and S4.
S4: The S4 pocket is hydrophobic in nature and the floor of the pocket is formed by Trp-215 residue. The residues Phe-174 and Tyr-99 of FXa join Trp-215 to form an aromatic box that is able to bind aliphatic, aromatic and positively charged fragments. Because of the binding to positively charged entities, it can be described as a cation hole.