LINKAGE BETWEEN INFLAMMATION AND COAGULATION - AN UPDATE ON THE MOLECULAR-BASIS OF THE CROSSTALK

Inflammation and coagulation cannot be considered as two separate proc esses, since there are several connecting points making them part of u nique, defensive host response. The endothelium can be considered as t he first link between inflammation and coagulation, since damaged endo thelium during inflammation represents a surface where proteins involv ed in both coagulation and the development of inflammation are express ed. During inflammation, cytokines modulate the coagulation system by downregulating the expression of thrombomodulin and the activation of protein C pattern but, at the same time, they induce the expression of tissue factor, modifying, in this way, the balance between procoagula nt and anticoagulant activities. At the same time, at the site of tiss ue injury, platelets become activated and release several mediators th at modify tissue integrity. Thrombin, formed following activation of t he coagulation cascade, is essential to promote haemostasis but also s timulates several cell functions, including chemotaxis and mitogenesis , which are responsible for the spreading of the lesion and the tissue repair process. Therefore, in the study of inflammation the involveme nt of the coagulation pathway has to be taken into account, since the interaction between coagulation and inflammation pathways is a critica l issue.