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Crit Care Med. 2010 Feb;38(2 Suppl):S26-34. doi: 10.1097/CCM.0b013e3181c98d21.

Inflammation and coagulation.

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Department of Medicine, Academic Medical Center, University of Amsterdam, Meibergdreef, Amsterdam, The Netherlands.


In the pathogenesis of sepsis, inflammation and coagulation play a pivotal role. Increasing evidence points to an extensive cross-talk between these two systems, whereby inflammation leads to activation of coagulation, and coagulation also considerably affects inflammatory activity. Molecular pathways that contribute to inflammation-induced activation of coagulation have been precisely identified. Pro-inflammatory cytokines and other mediators are capable of activating the coagulation system and down-regulating important physiologic anticoagulant pathways. Activation of the coagulation system and ensuing thrombin generation is dependent on expression of tissue factor and the simultaneous down-regulation of endothelial-bound anticoagulant mechanisms and endogenous fibrinolysis. Conversely, activated coagulation proteases may affect specific cellular receptors on inflammatory cells and endothelial cells and thereby modulate the inflammatory response.

[Indexed for MEDLINE]

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