揭开错综复杂的网络:补体激活决定败血症诱发凝血病的发病机制

IF 4.7 3区 医学 Q2 IMMUNOLOGY Journal of Innate Immunity Pub Date : 2024-01-01 Epub Date: 2024-05-31 DOI:10.1159/000539502
Xin Wei, Ye Tu, Shuhong Bu, Guimei Guo, Hongbin Wang, Zhibin Wang
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引用次数: 0

摘要

脓毒症相关凝血病特指广泛的全身性凝血活化,伴随着出血和器官损伤的高风险,严重者表现为弥散性血管内凝血(DIC),甚至发展为多器官功能障碍综合征(MODS)。补体系统和凝血系统分别作为先天免疫和止血的主要支柱,在败血症后会被大量激活。脓毒症引起的补体、凝血和纤维蛋白溶解级联功能失调会导致 "血栓炎",最终扩大全身炎症反应,加速 MODS 的发展。最近的研究表明,补体系统的大量激活会加剧脓毒症引起的凝血,甚至导致 DIC,这表明抑制补体激活可能具有治疗脓毒症凝血病的潜力。脓毒症相关血栓形成涉及促凝因子的上调或激活、抗凝因子的下调或失活以及纤溶机制的损害。本综述旨在总结最新文献,分析脓毒症中补体系统激活导致凝血级联异常的潜在分子机制。
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Unraveling the Intricate Web: Complement Activation Shapes the Pathogenesis of Sepsis-Induced Coagulopathy.

Background: Sepsis-associated coagulopathy specifically refers to widespread systemic coagulation activation accompanied by a high risk of hemorrhage and organ damage, which in severe cases manifests as disseminated intravascular coagulation (DIC), or even develops into multiple organ dysfunction syndrome (MODS). The complement system and the coagulation system as the main columns of innate immunity and hemostasis, respectively, undergo substantial activation after sepsis.

Summary: Dysfunction of the complement, coagulation/fibrinolytic cascades caused by sepsis leads to "thromboinflammation," which ultimately amplifies the systemic inflammatory response and accelerates the development of MODS. Recent studies have revealed that massive activation of the complement system exacerbates sepsis-induced coagulation and even results in DIC, which suggests that inhibition of complement activation may have therapeutic potential in the treatment of septic coagulopathy.

Key messages: Sepsis-associated thrombosis involves the upregulation or activation of procoagulant factors, down-regulation or inactivation of anticoagulant factors, and impairment of the fibrinolytic mechanism. This review aims to summarize the latest literature and analyze the underlying molecular mechanisms of the activation of the complement system on the abnormal coagulation cascades in sepsis.

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来源期刊
Journal of Innate Immunity
Journal of Innate Immunity 医学-免疫学
CiteScore
10.50
自引率
1.90%
发文量
35
审稿时长
7.5 months
期刊介绍: The ''Journal of Innate Immunity'' is a bimonthly journal covering all aspects within the area of innate immunity, including evolution of the immune system, molecular biology of cells involved in innate immunity, pattern recognition and signals of ‘danger’, microbial corruption, host response and inflammation, mucosal immunity, complement and coagulation, sepsis and septic shock, molecular genomics, and development of immunotherapies. The journal publishes original research articles, short communications, reviews, commentaries and letters to the editors. In addition to regular papers, some issues feature a special section with a thematic focus.
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