Molecular Neurotrauma and Haemostasis, Australian Centre for Blood Diseases, Monash University, Melbourne, Vic., Australia.
Transfusion Research Unit and Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Vic., Australia.
Br J Haematol. 2018 Mar;180(6):782-798. doi: 10.1111/bjh.15062. Epub 2017 Dec 19.
Coagulation and innate immunity are linked evolutionary processes that orchestrate the host defence against invading pathogens and injury. The complement system is integral to innate immunity and shares numerous interactions with components of the haemostatic pathway, helping to maintain physiological equilibrium. The term 'immunothrombosis' was introduced in 2013 to embrace this process, and has become an area of much recent interest. What is less apparent in the literature however is an appreciation of the clinical manifestations of the coagulation-complement interaction and the consequences of dysregulation of either system, as seen in many inflammatory and thrombotic disease states, such as sepsis, trauma, atherosclerosis, antiphospholipid syndrome (APS), paroxysmal nocturnal haemoglobinuria (PNH) and some thrombotic microangiopathies to name a few. The growing appreciation of this immunothrombotic phenomenon will foster the drive for novel therapies in these disease states, including anticoagulants as immunomodulators and targeted molecular therapies.
凝血与先天免疫是进化过程中的两个关联过程，它们共同协调宿主对入侵病原体和损伤的防御。补体系统是先天免疫的重要组成部分，与止血途径的许多成分相互作用，有助于维持生理平衡。“免疫血栓形成”一词于 2013 年被引入，以包含这一过程，并成为近期的一个热门研究领域。然而，文献中对凝血-补体相互作用的临床表现以及两个系统失调的后果的认识还不够，这种失调在许多炎症和血栓性疾病状态中都可见到，如脓毒症、创伤、动脉粥样硬化、抗磷脂综合征 (APS)、阵发性睡眠性血红蛋白尿症 (PNH) 和一些血栓性微血管病等。对这种免疫血栓形成现象的认识不断加深，将推动这些疾病状态中新型治疗方法的发展，包括作为免疫调节剂的抗凝剂和靶向分子疗法。
