Prothrombin is the zymogen precursor of the clotting enzyme thrombin, which is generated by two sequential cleavages at R271 and R320 by the prothrombinase complex. The structure of prothrombin is currently unknown. Prethrombin-1 differs from prothrombin for the absence of 155 residues in the N-terminal domain and is composed of a single polypeptide chain containing fragment 2 (residues 156-271), A chain (residues 272-320), and B chain (residues 321-579). The X-ray crystal structure of prethrombin-1 solved at 2.2-Å resolution shows an overall conformation significantly different (rmsd ¼ 3.6 Å) from that of its active form meizothrombin desF1 carrying a cleavage at R320. Fragment 2 is rotated around the y axis by 29°and makes only few contacts with the B chain. In the B chain, the oxyanion hole is disrupted due to absence of the I16-D194 ion pair and the Na þ binding site and adjacent primary specificity pocket are highly perturbed. A remarkable feature of the structure is that the autolysis loop assumes a helical conformation enabling W148 and W215, located 17 Å apart in meizothrombin desF1, to come within 3.3 Å of each other and completely occlude access to the active site. These findings suggest that the zymogen form of thrombin possesses conformational plasticity comparable to that of the mature enzyme and have significant implications for the mechanism of prothrombin activation and the zymogen → protease conversion in trypsin-like proteases.X-ray crystallography | blood coagulation | E* form A ctivation of trypsin-like proteases requires proteolytic processing of an inactive zymogen precursor (1) that occurs at the identical position in all known members of the family, i.e., between residues 15 and 16 (chymotrypsin numbering). The nascent N terminus induces formation of an ion pair with the highly conserved D194 that organizes both the oxyanion hole and primary specificity pocket for substrate binding and catalysis (2, 3). Through this mechanism, the zymogen irreversibly converts into the mature enzyme and affords regulation of catalytic activity. Importance of this paradigm is particularly evident in the activation, progression, and amplification of enzyme cascades, where each component acts as a substrate in the zymogen form in one step and as an enzyme in the subsequent step (4). Yet, recent findings suggest that this paradigm needs revision to account for the conformational plasticity of the protein acting as an enzyme or substrate (5, 6).In the blood coagulation cascade, the protease thrombin is generated from the zymogen prothrombin by the prothrombinase complex, composed of factors Va and Xa, phospholipid membranes, and Ca 2þ (7). Prothrombin is composed of a Gla domain, two kringle domains and the trypsin-like catalytic domain (Fig. 1). The prothrombinase complex converts prothrombin to thrombin along two pathways by cleaving sequentially at R271 and R320 (prothrombin numbering). Initial cleavage at R320 (R15 in the chymotrypsin numbering) between the A and B chains is the preferred pathway under phy...