The leech-derived anticoagulant
hirudin is post-translationally sulfated on tyrosine 63, resulting in a >10-fold increase in its affinity for thrombin. We report the structure of a biosynthetic sulfo-
hirudin complexed to thrombin solved to 1.84 Å resolution and show that sulfation is responsible for a salt bridge and an extended hydrogen-bond network that taken together account for the increased affinity of sulfo-
hirudin for thrombin. We also identify a divalent cation binding site at the interface between the two subunits of
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-thrombin that may modulate the physiological activity of thrombin.