Procoagulant Response of the Endothelium and Monocytes

Abstract

Tissue factor (TF), an integral membrane protein located on the surface of a variety of different cell types, is considered to be the primary triggering agent for the coagulation cascade in normal hemostasis (Nemerson 1988; Rapaport 1990; Gailani and Broze 1991). In addition, pathologic expression of TF in endothelial cells and monocytes is implicated as an underlying cause of the coagulopathy associated with a variety of thrombohemorrhagic disorders, including septic shock. This chapter will describe the regulation of TF expression (and alterations in expression of other factors important in regulating the coagulation system) in two vascular cell types, monocytes and endothelial cells, in response to inflammatory mediators that are likely to underlie the pathogenic activation of the blood coagulation system observed in gram-negative sepsis.