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Protein S

Drugs and Chemicals · NLM MeSH · updated 2026-10-31 · version 1

Citations verified against PubMedNot yet clinician-reviewed10 referencesApproximately 4 min read

The vitamin K-dependent cofactor of activated protein C.

Table of Contents

1. Definition2. Research landscape3. Reading the evidence4. Open-access studies5. Key reviews6. References7. About this article

Definition and research guide

This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.

Content available: 4 complete abstracts (862 words), 10 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.

Definition

The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S; (protein S deficiency); can lead to recurrent venous and arterial thrombosis.

Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.

Also known as: Protein S, Vitamin K-Dependent; Protein S, Vitamin K Dependent; Vitamin K-Dependent Protein S; Vitamin K Dependent Protein S; Cofactor Protein S; Protein S, Cofactor.

Where it fits in the MeSH classification

Broader topics
Glycoproteins; Blood Proteins; Blood Coagulation Factor Inhibitors

Related concepts

  • Protein
  • Deficiency

Research landscape

PubMed indexes 2,447 records tagged with the MeSH heading “Protein S” (counts retrieved 2026-10-31). 253 of them (10.3%) were published from 2020 onward, and the busiest period so far is through 1999 with 1,055 records.

Reviews account for 318 records (13.0%) and meta-analyses for 8. Randomized controlled trials number 54 (2.2%) as a share of all records on the topic.

PubMed records by publication periodthrough 1999: 1,055 records; 2000-2009: 613 records; 2010-2019: 526 records; 2020 onward: 253 records1,055through 19996132000-20095262010-20192532020 onward
Records in PubMed indexed with this heading, by publication period. Real counts from NCBI E-utilities; the final period covers only part of the current year. Volume reflects how much has been published, not how strong the evidence is.
Show the data
PeriodRecords
through 19991,055
2000-2009613
2010-2019526
2020 onward253
Share of records by publication typeReviews: 13.0 percent; Meta-analyses: 0.3 percent; Randomized controlled trials: 2.2 percentReviews13.0% (318)Meta-analyses0.3% (8)Randomized controlled trials2.2% (54)
Share of all PubMed records on this heading that carry each publication type. Types overlap with other records, so the shares do not sum to 100%.
Publication-type chart data
Publication types among 2,447 PubMed records
TypeRecordsShare
Reviews31813.0%
Meta-analyses80.3%
Randomized controlled trials542.2%

Method: PubMed query "Protein S"[MeSH Terms] with publication-type and date filters, retrieved 2026-10-31.

Reading the evidence in drugs and chemicals

Studies of a chemical or drug can answer very different questions: what it is and how it behaves in cells and animals, how the body handles it, and whether it changes outcomes in people. Laboratory and animal findings often do not carry over to patients, and observational studies of exposures are confounded by who uses a substance and why. Nothing on this page is a recommendation to use, avoid, start or stop any substance or medicine; talk to a qualified clinician or pharmacist about your own situation. Check the dose, the species, the comparison group and whether a patient-relevant outcome was measured.

Evidence from open-access studies

These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.

Study comparison — selected abstracts, not a systematic review
Study / authorsYearSource label / designEurope PMC citationsLicence / source
Differential TAM receptor-ligand-phospholipid interactions delimit differential TAM bioactivities
Lew ED, Oh J, Burrola PG, Lax I, Zagórska A, Través PG, et al.
2014Research article
Design not recorded in structured metadata
232cc by
PMID 25265470 · DOI · PMC4206827
MDD-Palm: Identification of protein S-palmitoylation sites with substrate motifs based on maximal dependence decomposition
Weng SL, Kao HJ, Huang CH, Lee TY
2017Research article
Design not recorded in structured metadata
31cc by
PMID 28662047 · DOI · PMC5491019
S-Layer Protein-Based Biosensors
Schuster B
2018Research article
Design not recorded in structured metadata
24cc by
PMID 29641511 · DOI · PMC6023001
Protein S Enhances the Phagocytosis of Phosphatidylserine-Exposing Erythrocytes: Implications in Sickle Cell Disease
Auditeau C, Fricot A, Gauthier R, Sissoko A, Cacan Z, Gounou C, et al.
2026Research article
Design not recorded in structured metadata
1cc by
PMID 41137641 · DOI · PMC12669952

Differential TAM receptor-ligand-phospholipid interactions delimit differential TAM bioactivities [1]

Research article Lew ED, Oh J, Burrola PG, Lax I, Zagórska A, Través PG, et al. · · 2014 · cited 232 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
The TAM receptor tyrosine kinases Tyro3, Axl, and Mer regulate key features of cellular physiology, yet the differential activities of the TAM ligands Gas6 and Protein S are poorly understood.
Closing excerpt
In two settings of TAM-dependent homeostatic phagocytosis, Mer plays a predominant role while Axl is dispensable, and activation of Mer by Protein S is sufficient to drive phagocytosis.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (150 words)

The TAM receptor tyrosine kinases Tyro3, Axl, and Mer regulate key features of cellular physiology, yet the differential activities of the TAM ligands Gas6 and Protein S are poorly understood. We have used biochemical and genetic analyses to delineate the rules for TAM receptor-ligand engagement and find that the TAMs segregate into two groups based on ligand specificity, regulation by phosphatidylserine, and function. Tyro3 and Mer are activated by both ligands but only Gas6 activates Axl. Optimal TAM signaling requires coincident TAM ligand engagement of both its receptor and the phospholipid phosphatidylserine (PtdSer): Gas6 lacking its PtdSer-binding 'Gla domain' is significantly weakened as a Tyro3/Mer agonist and is inert as an Axl agonist, even though it binds to Axl with wild-type affinity. In two settings of TAM-dependent homeostatic phagocytosis, Mer plays a predominant role while Axl is dispensable, and activation of Mer by Protein S is sufficient to drive phagocytosis.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 25265470 · DOI · PMC4206827

MDD-Palm: Identification of protein S-palmitoylation sites with substrate motifs based on maximal dependence decomposition [2]

Research article Weng SL, Kao HJ, Huang CH, Lee TY · · 2017 · cited 31 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
S-palmitoylation, the covalent attachment of 16-carbon palmitic acids to a cysteine residue via a thioester linkage, is an important reversible lipid modification that plays a regulatory role in a variety of physiological and biological processes.
Closing excerpt
tw/MDDPalm/.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (301 words)

S-palmitoylation, the covalent attachment of 16-carbon palmitic acids to a cysteine residue via a thioester linkage, is an important reversible lipid modification that plays a regulatory role in a variety of physiological and biological processes. As the number of experimentally identified S-palmitoylated peptides increases, it is imperative to investigate substrate motifs to facilitate the study of protein S-palmitoylation. Based on 710 non-homologous S-palmitoylation sites obtained from published databases and the literature, we carried out a bioinformatics investigation of S-palmitoylation sites based on amino acid composition. Two Sample Logo indicates that positively charged and polar amino acids surrounding S-palmitoylated sites may be associated with the substrate site specificity of protein S-palmitoylation. Additionally, maximal dependence decomposition (MDD) was applied to explore the motif signatures of S-palmitoylation sites by categorizing a large-scale dataset into subgroups with statistically significant conservation of amino acids. Single features such as amino acid composition (AAC), amino acid pair composition (AAPC), position specific scoring matrix (PSSM), position weight matrix (PWM), amino acid substitution matrix (BLOSUM62), and accessible surface area (ASA) were considered, along with the effectiveness of incorporating MDD-identified substrate motifs into a two-layered prediction model. Evaluation by five-fold cross-validation showed that a hybrid of AAC and PSSM performs best at discriminating between S-palmitoylation and non-S-palmitoylation sites, according to the support vector machine (SVM). The two-layered SVM model integrating MDD-identified substrate motifs performed well, with a sensitivity of 0.79, specificity of 0.80, accuracy of 0.80, and Matthews Correlation Coefficient (MCC) value of 0.45. Using an independent testing dataset (613 S-palmitoylated and 5412 non-S-palmitoylated sites) obtained from the literature, we demonstrated that the two-layered SVM model could outperform other prediction tools, yielding a balanced sensitivity and specificity of 0.690 and 0.694, respectively. This two-layered SVM model has been implemented as a web-based system (MDD-Palm), which is now freely available at http://csb.cse.yzu.edu.tw/MDDPalm/.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 28662047 · DOI · PMC5491019

S-Layer Protein-Based Biosensors [3]

Research article Schuster B · · 2018 · cited 24 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
The present paper highlights the application of bacterial surface (S-) layer proteins as versatile components for the fabrication of biosensors.
Closing excerpt
The present paper discusses and summarizes examples for the successful implementation of S-layer lattices on biosensor surfaces in order to give a comprehensive overview on the application potential of these bioinspired S-layer protein-based biosensors.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (159 words)

The present paper highlights the application of bacterial surface (S-) layer proteins as versatile components for the fabrication of biosensors. One technologically relevant feature of S-layer proteins is their ability to self-assemble on many surfaces and interfaces to form a crystalline two-dimensional (2D) protein lattice. The S-layer lattice on the surface of a biosensor becomes part of the interface architecture linking the bioreceptor to the transducer interface, which may cause signal amplification. The S-layer lattice as ultrathin, highly porous structure with functional groups in a well-defined special distribution and orientation and an overall anti-fouling characteristics can significantly raise the limit in terms of variety and the ease of bioreceptor immobilization, compactness of bioreceptor molecule arrangement, sensitivity, specificity, and detection limit for many types of biosensors. The present paper discusses and summarizes examples for the successful implementation of S-layer lattices on biosensor surfaces in order to give a comprehensive overview on the application potential of these bioinspired S-layer protein-based biosensors.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 29641511 · DOI · PMC6023001

Protein S Enhances the Phagocytosis of Phosphatidylserine-Exposing Erythrocytes: Implications in Sickle Cell Disease [4]

Research article Auditeau C, Fricot A, Gauthier R, Sissoko A, Cacan Z, Gounou C, et al. · · 2026 · cited 1 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
The major anticoagulant Protein S (PROS1) also contributes to the phagocytosis of apoptotic cells by bridging exposed phosphatidylserine (PtdSer) to the MerTK receptor on macrophages (efferocytosis).
Closing excerpt
This deeper understanding of physiological and pathological erythrophagocytosis opens new therapeutic approaches targeting PROS1 in SCD.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (252 words)

The major anticoagulant Protein S (PROS1) also contributes to the phagocytosis of apoptotic cells by bridging exposed phosphatidylserine (PtdSer) to the MerTK receptor on macrophages (efferocytosis). Whether PROS1 is involved in the splenic clearance of PtdSer-positive senescent and altered erythrocytes such as erythrocyte ghosts (eryghosts) is unknown. Here, we investigate the contribution of PROS1 and MerTK to the phagocytosis of intact RBC and eryghosts in healthy subjects and patients with sickle cell disease (SCD). We show that PROS1 enhances the phagocytosis of ionomycin-treated PtdSer-positive erythrocytes and of eryghosts generated in vitro. We confirm that eryghosts circulate in patients with SCD at higher levels than in healthy subjects and observe increased hemolysis and decreased levels of plasmatic PROS1 in patients with the highest concentration of eryghosts. The proportion of circulating eryghosts is correlated with the intensity of hyposplenism, and eryghosts are less frequently observed in sections of SCD compared to control spleens. We demonstrate that circulating eryghosts are procoagulant and adhere to endothelial cells. In SCD, PROS1 enhances their phagocytosis in a MerTK-dependent manner but has no such effect on intact erythrocytes. PROS1 is therefore involved in erythrophagocytosis, a physiological process insufficient in patients with SCD due to intense intravascular hemolysis and hyposplenism, leading to PROS1 consumption and the abnormal persistence of eryghosts in circulation. PROS1 deficiency may in turn initiate a pathogenic loop, enhancing unregulated activation of coagulation and defective clearance of procoagulant and adherent eryghosts. This deeper understanding of physiological and pathological erythrophagocytosis opens new therapeutic approaches targeting PROS1 in SCD.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 41137641 · DOI · PMC12669952

Key reviews and meta-analyses

The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.

  • Research article TAM receptors, Gas6, and protein S: roles in inflammation and hemostasis [5]
    van der Meer JH, van der Poll T, van 't Veer C · Blood · 2014 · cited 285 times (Europe PMC)
  • Research article Gas6 and protein S. Vitamin K-dependent ligands for the Axl receptor tyrosine kinase subfamily [6]
    Hafizi S, Dahlbäck B · FEBS J · 2006 · cited 284 times (Europe PMC)
  • Research article Coagulation, inflammation, and apoptosis: different roles for protein S and the protein S-C4b binding protein complex [7]
    Rezende SM, Simmonds RE, Lane DA · Blood · 2004 · cited 147 times (Europe PMC)
  • Research article Aberrant protein S-nitrosylation contributes to the pathophysiology of neurodegenerative diseases [8]
    Nakamura T, Prikhodko OA, Pirie E, Nagar S, Akhtar MW, Oh CK, et al. · Neurobiol Dis · 2015 · cited 136 times (Europe PMC)
  • Research article Protein S deficiency: a clinical perspective [9]
    ten Kate MK, van der Meer J · Haemophilia · 2008 · cited 130 times (Europe PMC)
  • Research article Ion channel regulation by protein palmitoylation [10]
    Shipston MJ · J Biol Chem · 2011 · cited 122 times (Europe PMC)

References

  1. Lew ED, Oh J, Burrola PG, Lax I, Zagórska A, Través PG, et al.. Differential TAM receptor-ligand-phospholipid interactions delimit differential TAM bioactivities. . 2014. PMID 25265470 · DOI · PMC4206827
  2. Weng SL, Kao HJ, Huang CH, Lee TY. MDD-Palm: Identification of protein S-palmitoylation sites with substrate motifs based on maximal dependence decomposition. . 2017. PMID 28662047 · DOI · PMC5491019
  3. Schuster B. S-Layer Protein-Based Biosensors. . 2018. PMID 29641511 · DOI · PMC6023001
  4. Auditeau C, Fricot A, Gauthier R, Sissoko A, Cacan Z, Gounou C, et al.. Protein S Enhances the Phagocytosis of Phosphatidylserine-Exposing Erythrocytes: Implications in Sickle Cell Disease. . 2026. PMID 41137641 · DOI · PMC12669952
  5. van der Meer JH, van der Poll T, van 't Veer C. TAM receptors, Gas6, and protein S: roles in inflammation and hemostasis. Blood. 2014. PMID 24596417 · DOI
  6. Hafizi S, Dahlbäck B. Gas6 and protein S. Vitamin K-dependent ligands for the Axl receptor tyrosine kinase subfamily. FEBS J. 2006. PMID 17064312 · DOI
  7. Rezende SM, Simmonds RE, Lane DA. Coagulation, inflammation, and apoptosis: different roles for protein S and the protein S-C4b binding protein complex. Blood. 2004. PMID 12907438 · DOI
  8. Nakamura T, Prikhodko OA, Pirie E, Nagar S, Akhtar MW, Oh CK, et al.. Aberrant protein S-nitrosylation contributes to the pathophysiology of neurodegenerative diseases. Neurobiol Dis. 2015. PMID 25796565 · DOI · PMC4575233
  9. ten Kate MK, van der Meer J. Protein S deficiency: a clinical perspective. Haemophilia. 2008. PMID 18479427 · DOI
  10. Shipston MJ. Ion channel regulation by protein palmitoylation. J Biol Chem. 2011. PMID 21216969 · DOI · PMC3058972

About this article

Sources
NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
Verification
Every reference was resolved against PubMed on 2026-10-31; title, year and DOI matched.
Review state
automated source verified; no human expert review has been recorded yet.
Version
1, last updated 2026-10-31.

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At a glance

2,447
PubMed records on this heading
10%
published since 2020
318
review articles
54
randomized trials
10
verified references below

Counts come from PubMed on 2026-10-31; they show how much has been written, not how strong the evidence is.

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