Piazza Ornella, Scarpati Giuliana, Cotena Simona, Lonardo Maria, Tufano Rosalba
Università degli Studi di Napoli Federico II, Anestesiologia e Rianimazione, Napoli, Italy.
Neurol Int. 2010 Jun 21;2(1):e1. doi: 10.4081/ni.2010.e1.
The complex picture of inflammation and coagulation alterations comes to life in acute stroke phases. Increasing evidence points to a strong interaction and extensive crosstalk between the inflammation and coagulation systems: the interest towards this relationship has increased since recent experimental research showed that the early administration of antithrombin III (ATIII) decreases the volume of ischemia in mice and might be neuroprotective, playing an antiinflammatory role.We aimed to establish the extent of the relationship among markers of inflammation (S100B and IL-18) and procoagulant and fibrinolytic markers (ATIII, thrombin-antithrombin III complex (TAT), Fibrin Degradation Products (FDP), D-dimer) in 13 comatose patients affected by focal cerebral ischemia.Plasma levels of TAT, D-dimer and FDP, IL18 and S100B were increased. IL-18 and S100B high serum levels in ischemic patients suggest an early activation of the inflammatory cascade in acute ischemic injury.The basic principles of the interaction between inflammatory and coagulation systems are revised, from the perspective that simultaneous modulation of both coagulation and inflammation, rather than specific therapies aimed at one of these systems could be more successful in stroke therapy.
炎症和凝血改变的复杂情况在急性卒中阶段显现出来。越来越多的证据表明炎症和凝血系统之间存在强烈的相互作用和广泛的串扰：自从最近的实验研究表明早期给予抗凝血酶III（ATIII）可减少小鼠的缺血体积并且可能具有神经保护作用、发挥抗炎作用以来，对这种关系的关注有所增加。我们旨在确定13例局灶性脑缺血昏迷患者中炎症标志物（S100B和IL-18）与促凝血和纤溶标志物（ATIII、凝血酶 - 抗凝血酶III复合物（TAT）、纤维蛋白降解产物（FDP）、D - 二聚体）之间关系的程度。TAT、D - 二聚体、FDP、IL18和S100B的血浆水平升高。缺血患者中IL - 18和S100B的高血清水平表明急性缺血性损伤中炎症级联反应的早期激活。从凝血和炎症同时调节可能比针对这些系统之一的特定疗法在卒中治疗中更成功的角度，对炎症和凝血系统之间相互作用的基本原理进行了修订。
