Cicala C, Cirino G
Department of Experimental Pharmacology, University of Naples Federico II, Italy.
Life Sci. 1998;62(20):1817-24. doi: 10.1016/s0024-3205(97)01167-3.
Inflammation and coagulation cannot be considered as two separate processes, since there are several connecting points making them part of unique, defensive host response. The endothelium can be considered as the first link between inflammation and coagulation, since damaged endothelium during inflammation represents a surface where proteins involved in both coagulation and the development of inflammation are expressed. During inflammation, cytokines modulate the coagulation system by downregulating the expression of thrombomodulin and the activation of protein C pattern but, at the same time, they induce the expression of tissue factor, modifying, in this way, the balance between procoagulant and anticoagulant activities. At the same time, at the site of tissue injury, platelets become activated and release several mediators that modify tissue integrity. Thrombin, formed following activation of the coagulation cascade, is essential to promote haemostasis but also stimulates several cell functions, including chemotaxis and mitogenesis, which are responsible for the spreading of the lesion and the tissue repair process. Therefore, in the study of inflammation the involvement of the coagulation pathway has to be taken into account, since the interaction between coagulation and inflammation pathways is a critical issue.
炎症和凝血不能被视为两个独立的过程，因为存在多个连接点，使它们成为独特的防御性宿主反应的一部分。内皮可被视为炎症和凝血之间的第一个联系点，因为炎症期间受损的内皮代表了一个表达参与凝血和炎症发展的蛋白质的表面。在炎症过程中，细胞因子通过下调血栓调节蛋白的表达和蛋白C途径的激活来调节凝血系统，但同时，它们诱导组织因子的表达，从而改变促凝血和抗凝血活性之间的平衡。同时，在组织损伤部位，血小板被激活并释放多种改变组织完整性的介质。凝血级联激活后形成的凝血酶对于促进止血至关重要，但它也刺激多种细胞功能，包括趋化性和有丝分裂，这些功能负责病变的扩散和组织修复过程。因此，在炎症研究中必须考虑凝血途径的参与，因为凝血和炎症途径之间的相互作用是一个关键问题。
