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Res Pract Thromb Haemost. 2019 May 23;3(3):331-339. doi: 10.1002/rth2.12217. eCollection 2019 Jul.

The contact pathway and sepsis.

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Division of Hematology-Medical Oncology Knight Cancer Institute Oregon Health & Science University Portland Oregon USA.
Department of Biomedical Engineering Oregon Health & Science University Portland Oregon USA.
Cardiovascular Biology Research Program Oklahoma Medical Research Foundation Oklahoma City Oklahoma USA.


The contact pathway factors XI (FXI) and XII (FXII) have been demonstrated to be largely dispensable for hemostasis, as their absence results in a mild to absent bleeding diathesis. A growing body of literature, however, suggests that the contact pathway contributes to the pathologic host response to certain infectious organisms that produces the often-fatal syndrome known as sepsis. The contact pathway factors serve as a central node connecting inflammation to coagulation, and may offer a potentially safe therapeutic target to mitigate the morbidity and mortality associated with sepsis. Herein, we summarize published in vivo and in vitro data that have explored the roles of the contact pathway in sepsis, and discuss potential clinical applications of novel FXI- and FXII-inhibiting drugs currently under investigation.


contact activation; factor XI; factor XII; kallikrein‐kinin system; sepsis

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