2013, Number 5
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Rev Fac Med UNAM 2013; 56 (5)
Thrombomodulin complex, protein C, endothelial protein C receptor in sepsis
Carrillo ER, de la Torre LT, Rosales AO
Language: Spanish
References: 33
Page: 14-25
PDF size: 215.14 Kb.
ABSTRACT
Septic shock is a leading cause of death in intensive care
units and a public health problem. Uncontrolled systemic
inflammatory response plays a critical role in the pathogenesis
of sepsis and septic shock. Alterations in the mechanisms
controlling coagulation and inflammation may lead to disseminated
intravascular coagulation. The interaction between
inflammation and coagulation is central to the pathogenesis
of both septic shock and sepsis. Thrombomodulin, protein C,
thrombin, and endothelial protein C receptor (T-PC-T-EPCR)
bind simultaneously forming a complex on the surface of
the endothelium. This complex maintains the endothelial
microenviroment in an anti-inflammatory and anticoagulant
state.
The objective of this paper is to review the critical role
that TM-PC-T-EPCR complex plays in the interaction between
inflammation and coagulation in sepsis and the use of recombinant
thrombomodulin as a new therapeutic alternative in
the management of serious sepsis and septic shock.
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