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BMC Medicine
Published in: BMC Medicine 1/2015

Open Access 01-12-2015 | Opinion

Causes and consequences of coagulation activation in sepsis: an evolutionary medicine perspective

Authors: Maiara Marx Luz Fiusa, Marco Antonio Carvalho-Filho, Joyce M Annichino-Bizzacchi, Erich V De Paula

Published in: BMC Medicine | Issue 1/2015

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Abstract

Background

Coagulation and innate immunity have been linked together for at least 450 million years of evolution. Sepsis, one of the world’s leading causes of death, is probably the condition in which this evolutionary link is more evident. However, the biological and the clinical relevance of this association have only recently gained the attention of the scientific community.

Discussion

During sepsis, the host response to a pathogen is invariably associated with coagulation activation. For several years, coagulation activation has been solely regarded as a mechanism of tissue damage, a concept that led to several clinical trials of anticoagulant agents for sepsis. More recently, this paradigm has been challenged by the failure of these clinical trials, and by a growing bulk of evidence supporting the concept that coagulation activation is beneficial for pathogen clearance. In this article we discuss recent basic and clinical data that point to a more balanced view of the detrimental and beneficial consequences of coagulation activation in sepsis.

Summary

Reappraisal of the association between coagulation and immune activation from an evolutionary medicine perspective offers a unique opportunity to gain new insights about the pathogenesis of sepsis, paving the way to more successful approaches in both basic and clinical research in this field.
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Metadata
Title
Causes and consequences of coagulation activation in sepsis: an evolutionary medicine perspective
Authors
Maiara Marx Luz Fiusa
Marco Antonio Carvalho-Filho
Joyce M Annichino-Bizzacchi
Erich V De Paula
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Medicine / Issue 1/2015
Electronic ISSN: 1741-7015
DOI
https://doi.org/10.1186/s12916-015-0327-2

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