“…• Heparin: binds to TFPI, releasing it and amplifying its binding to factor FVIIa; cotreatment with TFPI does not consistently reduce the mortality rate in septic patients Valentin et al (1994), Xu et al (2002), Abraham et al (2003), Tang et al (2007) • Heparin derivatives: sulfation dependent; N-/ O-desulfation eliminate binding ability Opal et al (1999), Heinzelmann and Bosshart (2005), Stasi et al (2017), Simpson and Trent (2019) • Bind and present LPS to CD14 and TLR4 on cell surfaces, enhance LPS recognition, or neutralize LPS sulfation patterns into circulation. HSs are responsible for multiple biological functions through interaction with various proteins in a homeostatic state; therefore HSs shedding interrupts crosstalk and communications between cells, contributing to abnormal inflammation, coagulation, and lipid metabolism systems under septic conditions (Hayashida et al, 2009;Arnold et al, 2020a). In an LPS-induced sepsis mouse model, pulmonary endothelial heparanase was activated in a TNF-α dependent manner (Schmidt et al, 2012).…”