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2012 ; 22
(1
): 49-62
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Inflammation and haemostasis
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Margetic S
Biochem Med (Zagreb)
2012[]; 22
(1
): 49-62
PMID22384519
show ga
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 mediators, 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, increased 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 progression of disease are systemic inflammatory response to infection or
sepsis and acute arterial thrombosis as a consequence of ruptured atherosclerotic
plaque. Close links between inflammation and haemostasis help explain the
prothrombotic tendency in these two clinical conditions in which inflammation
shifts the haemostatic activity towards procoagulant state by the ability of
proinflammatory mediators to activate coagulation system and to inhibit
anticoagulant and fibrinolytic activities. This review summarizes the current
knowledge of the complex interactions in the bidirectional relationship between
inflammation and haemostasis.