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Báo cáo y học: "Science review: Role of coagulation protease cascades in sepsis"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về y học đề tài: Science review: Role of coagulation protease cascades in sepsis. | Available online http ccforum.eom content 7 2 123 Review Science review Role of coagulation protease cascades in sepsis Matthias Riewald1 and Wolfram Ruf2 Senior Research Associate Department of Immunology C204 The Scripps Research Institute La Jolla California USA 2Associate Professor Department of Immunology C204 The Scripps Research Institute La Jolla California USA Correspondence Wolfram Ruf ruf@scripps.edu Published online 1 October 2002 Critical Care 2003 7 123-129 DOI 10.1186 cc1825 This article is online at http ccforum.com content 7 2 123 2003 BioMed Central Ltd Print ISSN 1364-8535 Online ISSN 1466-609X Abstract Cellular signaling by proteases of the blood coagulation cascade through members of the protease-activated receptor PAR family can profoundly impact on the inflammatory balance in sepsis. The coagulation initiation reaction on tissue factor expressing cells signals through PAR1 and PAR2 leading to enhanced inflammation. The anticoagulant protein C pathway has potent anti-inflammatory effects and activated protein C signals through PAR1 upon binding to the endothelial protein C receptor. Activation of the coagulation cascade and the downstream endothelial cell localized anticoagulant pathway thus have opposing effects on systemic inflammation. This dichotomy is of relevance for the interpretation of preclinical and clinical data that document nonuniform responses to anticoagulant strategies in sepsis therapy. Keywords inflammatory balance protein C sepsis tissue factor Severe sepsis is an exceedingly common cause of death in medical and surgical intensive care units. The sepsis syndrome involves a complex series of events that are caused by an excessive stimulation of the innate immune system. During the course of this dysregulation the blood coagulation cascade is triggered leading to the clinical signs of disseminated intravascular coagulation and microvascular thrombosis. Microvascular thrombosis is controlled by the anticoagulant protein C PC .