The Interface between Inflammation and Coagulation in Cardiovascular Disease

Abstract

<jats:p>The intimate connection between coagulation and inflammation in the pathogenesis of vascular disease has moved more and more into focus of clinical research. This paper focuses on the essential components of this interplay in the settings of cardiovascular disease and acute coronary syndrome. Tissue factor, the main initiator of the extrinsic coagulation pathway, plays a central role via causing a proinflammatory response through activation of coagulation factors and thereby initiating coagulation and downstream cellular signalling pathways. Regarding activated clotting factors II, X, and VII, protease-activated receptors provide the molecular link between coagulation and inflammation. Hereby, PAR-1 displays deleterious as well as beneficial properties. Unravelling these interrelations may help developing new strategies to ameliorate the detrimental reciprocal aggravation of inflammation and coagulation.</jats:p>

Inhibition of coagulation proteases Xa and IIa decreases ischemia–reperfusion injuries in a preclinical renal transplantation model

“…7,10,11 In this context, factor Xa and thrombin induce the expression of proinflammatory markers and adhesion molecules, particularly in endothelial cells and blood mononuclear cells. 23,24 We show in our in vitro model of cold "ischemia-like" + "reperfusionlike" sequence that treatment of endothelial cells with EP217609 during cold "ischemia-like" period permits a significant decrease of endothelial activation by reducing TNFα mRNA expression, as well as the expression adhesion molecules ICAM-1 and VCAM-1 mRNA at the "reperfusion-like" period.…”

Cytokines and C-Reactive Protein-Trigger of Imbalance of the Hemostasis System during Inflammation

“…Intercellular communications between mononuclear phagocytes and immunocompetent cells are mediated by cytokines release. Cytokines participate in the integration of immune system components as well as in the systemic reaction of [3,16,20]. Therefore, such changes of cytokines' profile in our research reflect compensatory-adaptive response of an organism by way of immune system activation in acute inflammation process.…”

“…It is the cofactor for the activated plasma clotting factor VII (FVIIa) which catalyzes the activation of factor X and IX and leads to the generation of thrombin and thus, finally, of a fibrin clot. Under physiologic conditions TF is abundantly expressed only in the adventitia, nevertheless in many pathologic conditions its activation is induced by several inflammatory mediators such as IL-6, IL-1β and CRP [3,10]. On the other hand, the expression of TF on monocytes and macrophages is markedly stimulated by the presence of activated platelets and granulocytes.…”

Association between R353Q polymorphism for coagulative factor VII and severity of coronary artery disease in Iranian population

“…Recent research has supported the central role of coagulative factors in advancing atherosclerosis and causing coronary artery disease (CAD) [1][2][3]. In this regard, coagulation factor VII seems to have an essential role in the initiation and extension of coronary atherosclerosis [4,5].…”