The serpin ZPI is a protein Z (PZ)-dependent specific inhibitor of membrane-associated factor Xa (fXa) despite having an unfavorable P1 Tyr. PZ accelerates the inhibition reaction ϳ2000-fold in the presence of phospholipid and Ca 2؉ . To elucidate the role of PZ, we determined the x-ray structure of Gladomainless PZ (PZ ⌬GD ) complexed with protein Z-dependent proteinase inhibitor (ZPI). The PZ pseudocatalytic domain bound ZPI at a novel site through ionic and polar interactions. Mutation of four ZPI contact residues eliminated PZ binding and membrane-dependent PZ acceleration of fXa inhibition. Modeling of the ternary Michaelis complex implicated ZPI residues Glu-313 and Glu-383 in fXa binding. Mutagenesis established that only Glu-313 is important, contributing ϳ5-10-fold to rate acceleration of fXa and fXIa inhibition. Limited conformational change in ZPI resulted from PZ binding, which contributed only ϳ2-fold to rate enhancement. Instead, template bridging from membrane association, together with previously demonstrated interaction of the fXa and ZPI Gla domains, resulted in an additional ϳ1000-fold rate enhancement. To understand why ZPI has P1 tyrosine, we examined a P1 Arg variant. This reacted at a diffusion-limited rate with fXa, even without PZ, and predominantly as substrate, reflecting both rapid acylation and deacylation. P1 tyrosine thus ensures that reaction with fXa or most other arginine-specific proteinases is insignificant unless PZ binds and localizes ZPI and fXa on the membrane, where the combined effects of Gla-Gla interaction, template bridging, and interaction of fXa with Glu-313 overcome the unfavorability of P1 Tyr and ensure a high rate of reaction as an inhibitor.Blood coagulation is a complex process requiring tight regulation through the use of feedback loops and the involvement of proteinase-specific inhibitors (1). fXa, 4 in complex with its cofactor Va, plays a crucial role in blood coagulation, being directly involved in the generation of the final proteinase thrombin from its zymogen prothrombin. This reaction takes place on the membrane surface of activated platelets, with all three protein components interacting with the membrane surface, either through Gla domains in the case of fXa and prothrombin or the two C-type domains of factor Va. In addition, fXa is itself formed at the membrane surface through the action of factor IXa, in complex with its cofactor VIIIa, on factor X.To help prevent clot formation away from the site of injury, any fXa that dissociates from the membrane and diffuses away in the bloodstream must be efficiently inhibited. This is accomplished primarily by the serpin antithrombin, which, when allosterically activated by being bound to heparan sulfate chains on the surface of endothelial cells, is a rapid inactivator of fXa, as well as of other circulating arginine-specific proteinases, such as thrombin and factor IXa (2). The P1 residue 5 of antithrombin is arginine, in keeping with the substrate specificity of each of these proteinases. Interestingly, ...