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Fibrinolysis and Inflammation in Venous Thrombus Resolution

Clinical observations and accumulating laboratory evidence support a complex interplay between coagulation, inflammation, innate immunity and fibrinolysis in venous thromboembolism (VTE). VTE, which includes deep vein thrombosis (DVT) and pulmonary embolism (PE), and the subsequent complications of...

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Autores principales: Mukhopadhyay, Subhradip, Johnson, Tierra A., Duru, Nadire, Buzza, Marguerite S., Pawar, Nisha R., Sarkar, Rajabrata, Antalis, Toni M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6587539/
https://www.ncbi.nlm.nih.gov/pubmed/31258531
http://dx.doi.org/10.3389/fimmu.2019.01348
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author Mukhopadhyay, Subhradip
Johnson, Tierra A.
Duru, Nadire
Buzza, Marguerite S.
Pawar, Nisha R.
Sarkar, Rajabrata
Antalis, Toni M.
author_facet Mukhopadhyay, Subhradip
Johnson, Tierra A.
Duru, Nadire
Buzza, Marguerite S.
Pawar, Nisha R.
Sarkar, Rajabrata
Antalis, Toni M.
author_sort Mukhopadhyay, Subhradip
collection PubMed
description Clinical observations and accumulating laboratory evidence support a complex interplay between coagulation, inflammation, innate immunity and fibrinolysis in venous thromboembolism (VTE). VTE, which includes deep vein thrombosis (DVT) and pulmonary embolism (PE), and the subsequent complications of post-thrombotic syndrome (PTS), are significant causes of morbidity and mortality in patients. Clinical risk factors for VTE include cancer, major trauma, surgery, sepsis, inflammatory bowel disease, paralysis, prolonged periods of immobility, and aging. Abnormalities in venous blood flow or stasis initiates the activation of endothelial cells, and in concert with platelets, neutrophils and monocytes, propagates VTE in an intact vein. In addition, inflammatory cells play crucial roles in thrombus recanalization and restoration of blood flow via fibrinolysis and vascular remodeling. Faster resolution of the thrombus is key for improved disease prognosis. While in the clinical setting, anticoagulation therapy is successful in preventing propagation of venous thrombi, current therapies are not designed to inhibit inflammation, which can lead to the development of PTS. Animal models of DVT have provided many insights into the molecular and cellular mechanisms involved in the formation, propagation, and resolution of venous thrombi as well as the roles of key components of the fibrinolytic system in these processes. Here, we review the recent advances in our understanding of fibrinolysis and inflammation in the resolution of VTE.
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spelling pubmed-65875392019-06-28 Fibrinolysis and Inflammation in Venous Thrombus Resolution Mukhopadhyay, Subhradip Johnson, Tierra A. Duru, Nadire Buzza, Marguerite S. Pawar, Nisha R. Sarkar, Rajabrata Antalis, Toni M. Front Immunol Immunology Clinical observations and accumulating laboratory evidence support a complex interplay between coagulation, inflammation, innate immunity and fibrinolysis in venous thromboembolism (VTE). VTE, which includes deep vein thrombosis (DVT) and pulmonary embolism (PE), and the subsequent complications of post-thrombotic syndrome (PTS), are significant causes of morbidity and mortality in patients. Clinical risk factors for VTE include cancer, major trauma, surgery, sepsis, inflammatory bowel disease, paralysis, prolonged periods of immobility, and aging. Abnormalities in venous blood flow or stasis initiates the activation of endothelial cells, and in concert with platelets, neutrophils and monocytes, propagates VTE in an intact vein. In addition, inflammatory cells play crucial roles in thrombus recanalization and restoration of blood flow via fibrinolysis and vascular remodeling. Faster resolution of the thrombus is key for improved disease prognosis. While in the clinical setting, anticoagulation therapy is successful in preventing propagation of venous thrombi, current therapies are not designed to inhibit inflammation, which can lead to the development of PTS. Animal models of DVT have provided many insights into the molecular and cellular mechanisms involved in the formation, propagation, and resolution of venous thrombi as well as the roles of key components of the fibrinolytic system in these processes. Here, we review the recent advances in our understanding of fibrinolysis and inflammation in the resolution of VTE. Frontiers Media S.A. 2019-06-14 /pmc/articles/PMC6587539/ /pubmed/31258531 http://dx.doi.org/10.3389/fimmu.2019.01348 Text en Copyright © 2019 Mukhopadhyay, Johnson, Duru, Buzza, Pawar, Sarkar and Antalis. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Immunology
Mukhopadhyay, Subhradip
Johnson, Tierra A.
Duru, Nadire
Buzza, Marguerite S.
Pawar, Nisha R.
Sarkar, Rajabrata
Antalis, Toni M.
Fibrinolysis and Inflammation in Venous Thrombus Resolution
title Fibrinolysis and Inflammation in Venous Thrombus Resolution
title_full Fibrinolysis and Inflammation in Venous Thrombus Resolution
title_fullStr Fibrinolysis and Inflammation in Venous Thrombus Resolution
title_full_unstemmed Fibrinolysis and Inflammation in Venous Thrombus Resolution
title_short Fibrinolysis and Inflammation in Venous Thrombus Resolution
title_sort fibrinolysis and inflammation in venous thrombus resolution
topic Immunology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6587539/
https://www.ncbi.nlm.nih.gov/pubmed/31258531
http://dx.doi.org/10.3389/fimmu.2019.01348
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