Abstract

CARRILLO ESPER, Raúl; TORRE LEON, Teresa de la  and  ROSALES, Agustín Omar. Thrombomodulin complex, protein C, endothelial protein C receptor in sepsis. Rev. Fac. Med. (Méx.) [online]. 2013, vol.56, n.5, pp.14-25. ISSN 2448-4865.

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.

Keywords : Sepsis; septic shock; Thrombomodulin; Thrombin; Protein C; Endothelial protein C receptor.

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