␣-Thrombin has two separate electropositive binding exosites (anion binding exosite I, ABE-I and anion binding exosite II, ABE-II) that are involved in substrate tethering necessary for efficient catalysis. ␣-Thrombin catalyzes the activation of factor V and factor VIII following discrete proteolytic cleavages. Requirement for both anion binding exosites of the enzyme has been suggested for the activation of both procofactors by ␣-thrombin. We have used plasma-derived ␣-thrombin, -thrombin (a thrombin molecule that has only ABE-II available), and a recombinant prothrombin molecule rMZ-II (R155A/R284A/ R271A) that can only be cleaved at Arg 320 (resulting in an enzymatically active molecule that has only ABE-I exposed, rMZ-IIa) to ascertain the role of each exosite for procofactor activation. We have also employed a synthetic sulfated pentapeptide (DY(SO 3 , and Arg
1689. Cleavage of both procofactors by ␣-thrombin was significantly inhibited by D5Q1,2. In contrast, -thrombin was unable to cleave factor V at Arg 1545 and factor VIII at both Arg 372 and Arg
1689. The former is required for light chain formation and expression of optimum factor Va cofactor activity, whereas the latter two cleavages are a prerequisite for expression of factor VIIIa cofactor activity. -Thrombin was found to cleave factor V at Arg 709 and factor VIII at Arg 740 , albeit less efficiently than ␣-thrombin. The sulfated pentapeptide inhibited moderately both cleavages by -thrombin. Under similar experimental conditions, membrane-bound rMZ-IIa cleaved and activated both procofactor molecules. Activation of the two procofactors by membrane-bound rMZ-IIa was severely impaired by D5Q1,2. Overall the data demonstrate that ABE-I alone of ␣-thrombin can account for the interaction of both procofactors with ␣-thrombin resulting in their timely and efficient activation. Because formation of meizothrombin precedes that of ␣-thrombin, our findings also imply that meizothrombin may be the physiological activator of both procofactors in vivo in the presence of a procoagulant membrane surface during the early stages of coagulation.Blood clotting involves a multitude of proteins, which act in concert in response to vascular injury to produce the procoagulant enzyme thrombin, which in turn is responsible for the generation of the fibrin plug (1). The two procoagulant enzymatic complexes (i.e. intrinsic tenase and prothrombinase) that are critical for thrombin formation are similar in structure and composed of an enzyme, a cofactor, and the substrate associated on a cell surface in the presence of divalent metal ions. The intrinsic tenase complex is composed of the enzyme, factor IXa, and the cofactor, factor VIIIa, associated on the cell membrane in the presence of divalent metal ions. Similarly, the prothrombinase complex is composed of the enzyme, factor Xa, and the cofactor, factor Va, associated on a cell surface in the presence of divalent metal ions. Although both enzymes factor IXa and factor Xa alone, can activate factor X and prothrombin, r...