The Role of Leukocytes in Disseminated Intravascular Coagulation Associated with Sepsis

摘要: Leukocytes play a pivotal role in the pathogenesis of disseminated intravascular coagulation (DIC) and multiple organ failure associated with sepsis. Cytokines such as tumor necrosis factor-a (TNF-α) interleukin-1β (IL-1β) activate monocytes, neutrophils endothelial cells. TNF-α increases expression tissue factor on surfaces both monocytes cells decreases anticoagulant potential cells, thereby inducing coagulation. These cytokines also inhibit fibrinolytic activity by increasing production plasminogen activator inhibitor-1. to release various inflammatory mediators neutrophil elastase oxygen free radicals, which are capable damaging Activated damage adhering through interaction E-selectin or ICAM-1, leukocyte adhesion molecules, increased actions these cytokines. Both microthrombus formation cell could lead microcirculatory disturbances. Among physiological anticoagulants, antithrombin, activated protein C pathway inhibitor exert anti-inflammatory inhibiting activation. Gabexate mesilate nafamostat mesilaste, synthetic The reduction abnormalities responses using therapeutic agents be useful treatment DIC