The role of platelets in sepsis

被引:238
作者
de Stoppelaar, Sacha F. [1 ,2 ]
van 't Veer, Cornelis [1 ,2 ]
van der Poll, Tom [1 ,2 ,3 ]
机构
[1] Univ Amsterdam, Acad Med Ctr, Ctr Expt & Mol Med, NL-1105 AZ Amsterdam, Netherlands
[2] Univ Amsterdam, Acad Med Ctr, Ctr Infect & Immun Amsterdam, NL-1105 AZ Amsterdam, Netherlands
[3] Univ Amsterdam, Acad Med Ctr, Div Infect Dis, NL-1105 AZ Amsterdam, Netherlands
关键词
Platelet immunology; infectious diseases; inflammatory mediators; ACUTE LUNG INJURY; NEUTROPHIL EXTRACELLULAR TRAPS; CRITICALLY-ILL PATIENTS; ACTIVATED PLATELETS; P-SELECTIN; PULMONARY RECRUITMENT; ANTIPLATELET THERAPY; RENAL-FAILURE; SEPTIC SHOCK; EXPRESSION;
D O I
10.1160/TH14-02-0126
中图分类号
R5 [内科学];
学科分类号
100201 [内科学];
摘要
Platelets are small circulating anucleate cells that are of crucial importance in haemostasis. Over the last decade, it has become increasingly clear that platelets play an important role in inflammation and can influence both innate and adaptive immunity. Sepsis is a potentially lethal condition caused by detrimental host response to an invading pathogen. Dysbalanced immune response and activation of the coagulation system during sepsis are fundamental events leading to sepsis complications and organ failure. Platelets, being major effector cells in both haemostasis and inflammation, are involved in sepsis pathogenesis and contribute to sepsis complications. Platelets catalyse the development of hyperinflammation, disseminated intravascular coagulation and microthrombosis, and subsequently contribute to multiple organ failure. Inappropriate accumulation and activity of platelets are key events in the development of sepsis-related complications such as acute lung injury and acute kidney injury. Platelet activation readouts could serve as biomarkers for early sepsis recognition; inhibition of platelets in septic patients seems like an important target for immune-modulating therapy and appears promising based on animal models and retrospective human studies.
引用
收藏
页码:666 / 677
页数:12
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