Inflammation and coagulation

Crit Care Med. 2010 Feb;38(2 Suppl):S26-34. doi: 10.1097/CCM.0b013e3181c98d21.

Abstract

In the pathogenesis of sepsis, inflammation and coagulation play a pivotal role. Increasing evidence points to an extensive cross-talk between these two systems, whereby inflammation leads to activation of coagulation, and coagulation also considerably affects inflammatory activity. Molecular pathways that contribute to inflammation-induced activation of coagulation have been precisely identified. Pro-inflammatory cytokines and other mediators are capable of activating the coagulation system and down-regulating important physiologic anticoagulant pathways. Activation of the coagulation system and ensuing thrombin generation is dependent on expression of tissue factor and the simultaneous down-regulation of endothelial-bound anticoagulant mechanisms and endogenous fibrinolysis. Conversely, activated coagulation proteases may affect specific cellular receptors on inflammatory cells and endothelial cells and thereby modulate the inflammatory response.

Publication types

  • Review

MeSH terms

  • Antithrombins / physiology
  • Blood Coagulation / physiology*
  • Blood Coagulation Disorders / etiology
  • Blood Coagulation Disorders / immunology
  • Blood Coagulation Disorders / physiopathology
  • Blood Platelets / physiology
  • Down-Regulation / physiology
  • Fibrin / physiology
  • Fibrinolysin / physiology
  • Fibrinolysis / physiology
  • Humans
  • Inflammation / blood
  • Inflammation / complications
  • Inflammation / physiopathology*
  • Lipoproteins / physiology
  • Plasminogen / physiology
  • Protein C / physiology
  • Receptors, Proteinase-Activated / physiology
  • Thrombin / physiology

Substances

  • Antithrombins
  • Lipoproteins
  • Protein C
  • Receptors, Proteinase-Activated
  • lipoprotein-associated coagulation inhibitor
  • Fibrin
  • Plasminogen
  • Thrombin
  • Fibrinolysin