Pathogenesis and Therapy of Coagulation Disorders in Severe Acute Pancreatitis

Abstract

Ischemia superimposed upon pancreatic edema leads to acute necrotizing pancreatitis. One possible mechanism contributing to ischemia is intravascular thrombogenesis since fibrin deposits have been detected in pancreatic capillaries by electron microscope. Current experimental and clinical data provided compelling evidence that the disorders in the blood coagulation system play a critical role in the pathogenesis of severe acute pancreatitis (SAP). This leads to microcirculatory failure of intra- and extrapancreatic organs and multiple organ failure and increases the case fatality rate. However, the mechanism of coagulopathy underlying SAP is not yet clear, although some anticoagulant drugs have entered clinical practice showing improvement in prognosis. Thus, enhanced understanding of the process might improve the treatment strategies with safety and high efficacy. Herein, the pathogenesis of the coagulation system of SAP was reviewed with a focus on the coagulation pathway, intercellular interactions, and complement system, thereby illustrating some anticoagulant therapies and potential therapeutic targets.

NLRC4‐mediated pyroptosis was involved in coagulation disorders of acute pancreatitis

“…5 On the other hand, coagulation disorders lead to the microcirculation perfusion of intra-and extrapancreatic organs, inducing the progression of AP and even the occurrence of multiple organ failure. 5 Anticoagulation therapies are also considered as a potential treatment for AP, which have made significant progress in clinical practice. However, the underlying mechanisms of coagulation disorders have not completely clarified in AP.…”

The Crosstalk between Nephropathy and Coagulation Disorder: Pathogenesis, Treatment, and Dilemmas

“…As an important part of physiological hemostasis, coagulation is a complex process involving a series of cascade reactions between coagulation factors, which finally transform fibrinogen into insoluble fibrin, causing blood clotting (Figure 1). 1 Abnormalities in coagulation factors lead to coagulation disorders, resulting in thrombosis or bleeding. 1…”

“…1 Abnormalities in coagulation factors lead to coagulation disorders, resulting in thrombosis or bleeding. 1…”

“…1 Abnormalities in coagulation factors lead to coagulation disorders, resulting in thrombosis or bleeding. 1 As a blood filter and the most highly perfused organ, the kidney plays an im-portant role in regulating hemodynamics and blood components, which directly affects coagulation processes. 2 In fact, thrombosis is common in patients with nephrotic syndrome (NS) or CKD [3][4][5] or patients undergoing RRTs.…”

“…As an important part of physiological hemostasis, coagulation is a complex process involving a series of cascade reactions between coagulation factors, which finally transform fibrinogen into insoluble fibrin, causing blood clotting (Figure 1). 1 Abnormalities in coagulation factors lead to coagulation disorders, resulting in thrombosis or bleeding. 1 As a blood filter and the most highly perfused organ, the kidney plays an im-portant role in regulating hemodynamics and blood components, which directly affects coagulation processes.…”