Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai, China.
Cancer Center, Zhongshan Hospital, Fudan University, Shanghai, China.
Front Cell Infect Microbiol. 2021 Mar 17;11:653228. doi: 10.3389/fcimb.2021.653228. eCollection 2021.
Patients with sepsis commonly suffer from coagulation dysfunction and lead to the formation of thrombus. During the development of sepsis, neutrophils migrate from the circulating blood to infected tissues and mediate the formation of neutrophil extracellular traps (NETs) that kill pathogens. However, the overactivation of neutrophils can promote the formation of immunothrombosis and even cause disseminated intravascular coagulation (DIC), which damages microcirculation. The outcome of sepsis depends on early recognition and intervention, so clinical evaluation of NETs function may be a valuable biomarker for early diagnosis of sepsis. The interaction of NETs with platelets, complement, and endothelium mediates the formation of immunothrombosis in sepsis. Inhibiting the formation of NETs is also considered to be one of the potential treatments for sepsis. In this review, we will discuss the key role of neutrophils and NETs in sepsis and septic thrombosis, in order to reveal new mechanisms for thrombosis treatment of sepsis.
脓毒症患者常伴有凝血功能障碍,导致血栓形成。在脓毒症的发展过程中,中性粒细胞从循环血液迁移到感染组织,并介导中性粒细胞胞外诱捕网(NETs)的形成,从而杀死病原体。然而,中性粒细胞的过度激活会促进免疫血栓形成,甚至导致弥散性血管内凝血(DIC),从而损害微循环。脓毒症的结局取决于早期识别和干预,因此 NETs 功能的临床评估可能是脓毒症早期诊断的有价值的生物标志物。NETs 与血小板、补体和内皮的相互作用介导了脓毒症中免疫血栓的形成。抑制 NETs 的形成也被认为是脓毒症的潜在治疗方法之一。在这篇综述中,我们将讨论中性粒细胞和 NETs 在脓毒症和脓毒性血栓形成中的关键作用,以揭示脓毒症血栓治疗的新机制。