To be or not to be protease activated receptor-1 in activated protein C-initiated endothelial barrier protection?

Excerpt

The review by Looney and Matthay summarized recent progress in basic and preclinical research of activated protein C (APC), a novel therapeutic agent for the treatment of severe sepsis [1]. APC is traditionally an anticoagulant and profibrinolytic agent, and has been appreciated to possess anti-inflammatory and anti-apoptotic properties, yet the exact mechanisms by which APC executes its clinical effects in sepsis are not defined [2]. Emerging evidence has suggested that APC might exert its clinical benefit, at least in part, by maintaining endothelial barrier function [3, 4]. The authors reviewed conflicting results of endothelial barrier protection of APC in the literature and pointed out that caution must be taken to interpret cell culture experiments and their relationship to in vivo conditions. Indeed, one should exercise caution while reviewing controversial data. …