Is the neutrophil a 'prima donna' in the procoagulant process during sepsis?

Activation of the coagulation system is a fundamental host defense mechanism. Microorganisms that have invaded the body are trapped and disposed of in clots. Monocytes/macrophages are widely accepted as the main players in the procoagulant process; however, recent evidence suggests that neutrophils...

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Bibliographic Details
Published in:Critical care (London, England) England), 2014-07, Vol.18 (4), p.230-230, Article 230
Main Authors: Iba, Toshiaki, Miki, Takahiro, Hashiguchi, Naoyuki, Tabe, Yoko, Nagaoka, Isao
Format: Article
Language:English
Subjects:
Analysis
Blood Coagulation - immunology
Blood Coagulation - physiology
DNA binding proteins
Extracellular Traps - physiology
Fibrinolysis - physiology
Health aspects
Humans
Neutrophils - immunology
Neutrophils - physiology
Review
Sepsis - immunology
Sepsis - physiopathology
Thrombin
Thrombin - physiology
Thromboplastin - physiology
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Summary:Activation of the coagulation system is a fundamental host defense mechanism. Microorganisms that have invaded the body are trapped and disposed of in clots. Monocytes/macrophages are widely accepted as the main players in the procoagulant process; however, recent evidence suggests that neutrophils also play important roles. Tissue factor, which initiates the extrinsic coagulation cascade, is reportedly expressed on the surface of neutrophils, as well as on microparticles derived from neutrophils. Neutrophil extracellular traps (NETs) are another source of tissue factor. The components of NETs, such as DNA, histones, and granule proteins, also provide procoagulant activities. For instance, DNA initiates the intrinsic pathway, histones are a strong generator of thrombin, and granule proteins such as neutrophil elastase, cathepsin G and myeloperoxidase contribute to the suppression of the anticoagulation systems. Although understanding of the mechanisms that are involved in coagulation/fibrinolysis in sepsis has gradually progressed, the impact of neutrophils on thrombogenicity during sepsis remains to be addressed. Since the importance of the connection between coagulation and inflammation is advocated nowadays, further research on neutrophils is required.
ISSN:1364-8535
1466-609X
1364-8535
DOI:10.1186/cc13983