Factor XIa (FXIa) is a serine protease important for initiating the intrinsic pathway of blood coagulation. Protease nexin 2 (PN2) is a Kunitz-type protease inhibitor secreted by activated platelets and a physiologically important inhibitor of FXIa. Inhibition of FXIa by PN2 requires interactions between the two proteins that are confined to the catalytic domain of the enzyme and the Kunitz protease inhibitor (KPI) domain of PN2. Recombinant PN2KPI and a mutant form of the FXI catalytic domain (FXIac) were expressed in yeast, purified to homogeneity, co-crystallized, and the structure of the complex was solved at 2.6 Å (Protein Data Bank code 1ZJD). In this complex, PN2KPI has a characteristic, disulfide-stabilized double loop structure that fits into the FXIac active site. To determine the contributions of residues within PN2KPI to its inhibitory activity, selected point mutations in PN2KPI Coagulation factor XI (FXI) 4 is a unique homodimeric coagulation protein, present in human plasma at a concentration of ϳ30 nM, that is essential for normal hemostasis, as evidenced by the fact that FXI deficiency is associated with a hemorrhagic disorder (1). The zymogen FXI can bind to receptors (2-4), consisting of the glycoprotein Ib-IX-V complex (5) on the plasma membranes of activated human platelets, where it can be incorporated into platelet membrane microdomains (i.e. lipid rafts) (6) for efficient activation by thrombin or by FXIIa (7-10). The resulting enzyme, FXIa, can then activate the vitamin K-dependent protein, FIX, to initiate the consolidation phase of blood coagulation (1).A variety of important control mechanisms exist for regulating the activity of coagulation proteases in plasma. Several members of the serpin family have been proposed as physiological regulators of FXIa activity in plasma, including C1 inhibitor (11, 12), ␣-1-protease inhibitor (13, 14), antithrombin III (15), ␣-2-antiplasmin (16), and protease nexin 1 (17). However, a platelet secretory protein and member of the class of Kunitz-type inhibitors, protease nexin 2 (PN2), has recently been shown to be a much more potent and physiologically relevant FXIa inhibitor based on detailed kinetics studies (18 -23). PN2 is a ϳ120-kDa isoform of the Alzheimer -amyloid protein precursor (APP) that contains a Kunitz-type serine protease inhibitor (PN2KPI) domain (22). Platelets are an important source of several isoforms of APP, including the APP 751 isoform of PN2 (23, 24). Full-length APP is membraneassociated (25) and is processed by proteases in platelets (26, 27). Upon platelet activation by physiological stimulators, PN2 is secreted from ␣-granules into plasma and inhibits FXIa (22-24), suggesting a role for this protein in blood coagulation. PN2 is a slow, tight binding inhibitor of FXIa with K i of ϳ300 -500 pM (18,20,22). The KPI domain of PN2 is 57 amino acids in length (Glu 289 -Ile 345 in the 751-amino acid isoform of PN2) and is known to contain the entire FXIa inhibitory function of PN2 (19 -21, 28). Similarly, all of the information r...