Medizinische Klinik und Poliklinik I, Klinikum der Universität München, Ludwig-Maximilians- Universität, Munich, Germany.
Partner Site Munich Heart Alliance, DZHK (German Centre for Cardiovascular Research), Munich, Germany.
Front Immunol. 2023 Apr 5;14:1151926. doi: 10.3389/fimmu.2023.1151926. eCollection 2023.
Thrombosis is a frequent cause of cardiovascular mortality and hospitalization. Current antithrombotic strategies, however, target both thrombosis and physiological hemostasis and thereby increase bleeding risk. In recent years the pathophysiological understanding of thrombus formation has significantly advanced and inflammation has become a crucial element. Neutrophils as most frequent immune cells in the blood and their released mediators play a key role herein. Neutrophil-derived cathelicidin next to its strong antimicrobial properties has also shown to modulates thrombosis and thus presents a potential therapeutic target. In this article we review direct and indirect (immune- and endothelial cell-mediated) effects of cathelicidin on platelets and the coagulation system. Further we discuss its implications for large vessel thrombosis and consecutive thromboinflammation as well as immunothrombosis in sepsis and COVID-19 and give an outlook for potential therapeutic prospects.
血栓形成是心血管死亡率和住院率升高的一个常见原因。然而，目前的抗血栓形成策略针对血栓形成和生理止血，从而增加了出血风险。近年来，血栓形成的病理生理学认识有了显著进展，炎症已成为一个关键因素。中性粒细胞作为血液中最常见的免疫细胞及其释放的介质在此过程中发挥着关键作用。中性粒细胞衍生的抗菌肽除了具有强大的抗菌特性外，还被证明可以调节血栓形成，因此成为一个潜在的治疗靶点。本文综述了抗菌肽对血小板和凝血系统的直接和间接（免疫和内皮细胞介导）作用。此外，还讨论了其在大血管血栓形成及随后的血栓炎症、脓毒症和 COVID-19 中的免疫性血栓形成中的意义，并对潜在的治疗前景进行了展望。
