Biochemia Medica, Vol. 22 No. 1, 2012.
Review article
Inflammation and hemostasis
Sandra Margetic
; Department of Laboratory Haematology and Coagulation, University Department of Chemistry, Medical School University Hospital Center, Zagreb, Croatia
Abstract
Inflammation and haemostasis are interrelated pathophysiologic processes that considerably affect each other. In this bidirectional relationship, inflammation leads to activation of the haemostatic system that in turn also considerably influences inflammatory activity. Such, the haemostatic system acts in concert with the inflammatory cascade creating an inflammation-haemostasis cycle in which each activated process promotes the other and the two systems function in a positive feedback loop. The extensive crosstalk between immune and haemostatic systems occurs at level of all components of the haemostatic system including vascular endothelial cells, platelets, plasma coagulation cascade, physiologic anticoagulants and fibrinolytic activity. During inflammatory response, inflammatory medi-ators, in particular proinflammatory cytokines, play a central role in the effects on haemostatic system by triggering its disturbance in a number of mechanisms including endothelial cell dysfunction, increa-sed platelet reactivity, activation of the plasma coagulation cascade, impaired function of physiologic anticoagulants and suppressed fibrinolytic activity.
The two examples of pathophysiologic processes in which the tight interdependent relationship between inflammation and haemostasis considerably contribute to the pathogenesis and/or progres-sion of disease are systemic inflammatory response to infection or sepsis and acute arterial thrombo-sis as a consequence of ruptured atherosclerotic plaque. Close links between inflammation and hae-mostasis help explain the prothrombotic tendency in these two clinical conditions in which inflammati-on shifts the haemostatic activity towards procoagulant state by the ability of proinflammatory media-tors to activate coagulation system and to inhibit anticoagulant and fibrinolytic activities.
This review summarizes the current knowledge of the complex interactions in the bidirectional relation-ship between inflammation and haemostasis.
Keywords
inflammation; haemostasis; inflammation mediators; atherosclerosis; sepsis
Hrčak ID:
77388
URI
Publication date:
15.2.2012.
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