ABSTRACT
Tissue factor plays an essential role in the initiation of coagulation in vivo. In
severe conditions, including sepsis and acute lung injury, increased expression of
tissue factor may induce disseminated intravascular coagulation and fibrin deposition
in organs, which are believed to have a determining impact on patient outcome. Tissue
factor also acts as a signaling receptor and is involved in the systemic inflammatory
response, as in cancer progression and atherosclerosis. Interventions aiming at limiting
tissue factor activities have been evaluated in multiple experimental studies and
the observed results have supported the potential benefits for coagulation disorders,
inflammation, and survival. The effects of the main physiological inhibitor of tissue
factor, tissue factor pathway inhibitor, have been evaluated in two large clinical
trials in sepsis. Even though they are not associated with an improved outcome, the
observed data support further clinical studies.
KEYWORDS
Tissue factor - sepsis - animal models - tissue factor pathway inhibitor (TFPI) -
SIRS - DIC
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Pierre-Francois LaterreM.D.
Department of Critical Care Medicine, St. Luc University Hospital, Université Catholigue
de Louvan
Avenue Hippocrate 10, 1200 Brussels, Belgium
eMail: laterre@rean.ucl.ac.be