Hooper W Craig
Hematologic Disease Branch, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Curr Pharm Des. 2004;10(8):923-7. doi: 10.2174/1381612043452857.
Inflammation represents the interaction of the immune and coagulation systems in an attempt to restore normal hemostasis following injury. The underlying basis of the interrelationship between these two physiological systems revolves around the following: a) the activation of coagulation by inflammation, b) the augmentation of the inflammatory response by coagulation, c) the significant attenuation of inflammation by the anticoagulant response and d) the separate influence of the vascular endothelium on coagulation and inflammation as well as its mediation or control of the cross-talk between these two physiological systems. In hemostasis, the protein C anticoagulant pathway is a major mechanism that functions to prevent the development of a pathological thrombus through the regulation of the procoagulant pathway. The endothelium is essential in maintaining a physiological balance between the anticoagulant and procoagulant pathways with proinflammatory cytokines functioning, in part, to regulate endothelial-cell- surface associated coagulation and anticoagulation proteins. In addition to its anticoagulant properties, activated protein C can also function as a regulator of proinflammatory cytokine production. Current evidence suggests that activated protein C may act to control inflammation through NF-kappaB and/or nitric oxide synthase. A better understanding of the relationship between APC and inflammation may provide new targets for drug design.
炎症代表免疫和凝血系统的相互作用，旨在损伤后恢复正常止血。这两个生理系统之间相互关系的潜在基础围绕以下几点：a）炎症激活凝血，b）凝血增强炎症反应，c）抗凝反应显著减轻炎症，d）血管内皮对凝血和炎症的单独影响及其对这两个生理系统之间相互作用的介导或控制。在止血过程中，蛋白C抗凝途径是一种主要机制，通过调节促凝途径来防止病理性血栓的形成。内皮对于维持抗凝和促凝途径之间的生理平衡至关重要，促炎细胞因子部分发挥作用来调节内皮细胞表面相关的凝血和抗凝蛋白。除了其抗凝特性外，活化蛋白C还可作为促炎细胞因子产生的调节剂。目前的证据表明，活化蛋白C可能通过NF-κB和/或一氧化氮合酶来控制炎症。更好地理解活化蛋白C与炎症之间的关系可能为药物设计提供新的靶点。
