Endothelium: interface between coagulation and inflammation.
OBJECTIVE
To review the involvement of endothelial cells in the pathogenesis of coagulation abnormalities during severe infection, the differential role of proinflammatory cytokines in these mechanisms, and the cross talk between coagulation and inflammation.


METHODS
Published articles on experimental studies of coagulation activation during inflammation and clinical studies of patients with sepsis and associated hemostatic abnormalities.


CONCLUSIONS
The endothelium plays a central role in all major pathways involved in the pathogenesis of the hemostatic derangement observed during severe inflammation (i.e., initiation and regulation of thrombin generation and inhibition of fibrinolysis). Rather than being a unidirectional relationship, the interaction between inflammation and coagulation involves significant cross talk in which the endothelium seems to play a pivotal role.
Levi
Marcel
M
Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, The Netherlands.
ten Cate
Hugo
H
van der Poll
Tom
T
D000818:Animals; D001777:Blood Coagulation / Q000502:physiology; D001778:Blood Coagulation Disorders / Q000209:etiology*; D016207:Cytokines / Q000378:metabolism / Q000502:physiology*; D004730:Endothelium, Vascular / Q000378:metabolism / Q000502:physiology*; D006801:Humans; D007249:Inflammation / Q000150:complications* / Q000378:metabolism; D008074:Lipoproteins / Q000378:metabolism / Q000502:physiology*
D016207:Cytokines; D008074:Lipoproteins; C051928:lipoprotein-associated coagulation inhibitor