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Factor VIII Aurora (FVIII-R571S) is a naturally occurring, hyperactive gain-of-function variant of coagulation factor VIII (FVIII). Originally identified in a patient with severe, recurrent thrombosis, the variant features an Arg571Ser (or Arg590Ser by HGVS nomenclature) mutation in the A2 domain of FVIII. Recombinant FVIII-R571S exhibits a 10- to 20-fold increased affinity for activated factor IX (FIXa), which enhances the assembly and function of the intrinsic tenase (Xase) complex. This increased affinity also protects the activated cofactor (FVIIIa) from A2-domain dissociation and activated protein C (APC)-mediated inactivation, conferring functional APC resistance. FVIII-R571S is being investigated as a potential high-potency therapeutic candidate for the treatment of hemophilia A, demonstrating enhanced hemostatic efficacy in vivo compared to wild-type FVIII.
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