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Journal of Intensive Care

, 2:65

Recent advances in disseminated intravascular coagulation

Abstract

Thrombosis is generally considered harmful because it compromises the blood supply to organs. However, recent studies have suggested that thrombosis under certain circumstances plays a major physiological role in early immune defense against invading pathogens. This defensive role of thrombosis is now referred to as immunothrombosis. Activated monocytes and neutrophils are two major inducers of immunothrombosis. Monocytes and neutrophils are activated when they detect pathogen-associated molecular patterns PAMPs and damage-associated molecular patterns DAMPs. Detection of PAMPs and DAMPs triggers tissue factor expression on monocytes and neutrophil extracellular trap NET release by neutrophils, promoting immunothrombosis. Although tissue factor-mediated and NET-mediated immunothrombosis plays a role in early host defense against bacterial dissemination, uncontrolled immunothrombosis may lead to disseminated intravascular coagulation.

KeywordsImmunothrombosis Pathogen-associated molecular patterns PAMPs Damage-associated molecular patterns DAMPs Tissue factor Neutrophil extracellular traps NETs Disseminated intravascular coagulation DIC AbbreviationsPAMPspathogen-associated molecular patterns

DAMPsdamage-associated molecular patterns

NETsneutrophil extracellular traps

DICdisseminated intravascular coagulation

TMthrombomodulin

TFPItissue factor pathway inhibitor

ATantithrombin

LPSlipopolysaccharide

PRRspattern recognition receptors

HMGB1high mobility group box 1

cfDNAcell-free DNA

APACHE IIAcute Physiology and Chronic Health Evaluation II

SOFASequential Organ Failure Assessment

PAI-1plasminogen activator inhibitor type-1

APCactivated protein C

rhAPCrecombinant human activated protein C

rhsTMrecombinant human soluble thrombomodulin

TATthrombin-antithrombin complex

Electronic supplementary materialThe online version of this article doi:10.1186-s40560-014-0065-0 contains supplementary material, which is available to authorized users.

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Autor: Takashi Ito

Fuente: https://link.springer.com/







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