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The role of endothelial shear stress on haemodynamics, inflammation, coagulation and glycocalyx during sepsis
Sepsis is a multifactorial syndrome primarily determined by the host response to an invading pathogen. It is common, with over 48 million cases worldwide in 2017, and often lethal. The sequence of events in sepsis begins with the damage of endothelium within the microvasculature, as a consequence of...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7687012/ https://www.ncbi.nlm.nih.gov/pubmed/32951280 http://dx.doi.org/10.1111/jcmm.15895 |
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author | Lupu, Florea Kinasewitz, Gary Dormer, Kenneth |
author_facet | Lupu, Florea Kinasewitz, Gary Dormer, Kenneth |
author_sort | Lupu, Florea |
collection | PubMed |
description | Sepsis is a multifactorial syndrome primarily determined by the host response to an invading pathogen. It is common, with over 48 million cases worldwide in 2017, and often lethal. The sequence of events in sepsis begins with the damage of endothelium within the microvasculature, as a consequence of the inflammatory and coagulopathic responses to the pathogen that can progress to multiple organ failure and death. Most therapeutic interventions target the inflammation and coagulation pathways that act as an auto‐amplified vicious cycle, which, if unchecked can be fatal. Normal blood flow and shear stress acting on a healthy endothelium and intact glycocalyx have anti‐inflammatory, anticoagulant and self‐repairing effects. During early stages of sepsis, the vascular endothelium and its glycocalyx become dysfunctional, yet they are essential components of resuscitation and recovery from sepsis. The effects of shear forces on sepsis‐induced endothelial dysfunction, including inflammation, coagulation, complement activation and microcirculatory breakdown are reviewed. It is suggested that early therapeutic strategies should prioritize on the restoration of shear forces and endothelial function and on the preservation of the endothelial‐glycocalyx barrier. |
format | Online Article Text |
id | pubmed-7687012 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-76870122020-12-03 The role of endothelial shear stress on haemodynamics, inflammation, coagulation and glycocalyx during sepsis Lupu, Florea Kinasewitz, Gary Dormer, Kenneth J Cell Mol Med Reviews Sepsis is a multifactorial syndrome primarily determined by the host response to an invading pathogen. It is common, with over 48 million cases worldwide in 2017, and often lethal. The sequence of events in sepsis begins with the damage of endothelium within the microvasculature, as a consequence of the inflammatory and coagulopathic responses to the pathogen that can progress to multiple organ failure and death. Most therapeutic interventions target the inflammation and coagulation pathways that act as an auto‐amplified vicious cycle, which, if unchecked can be fatal. Normal blood flow and shear stress acting on a healthy endothelium and intact glycocalyx have anti‐inflammatory, anticoagulant and self‐repairing effects. During early stages of sepsis, the vascular endothelium and its glycocalyx become dysfunctional, yet they are essential components of resuscitation and recovery from sepsis. The effects of shear forces on sepsis‐induced endothelial dysfunction, including inflammation, coagulation, complement activation and microcirculatory breakdown are reviewed. It is suggested that early therapeutic strategies should prioritize on the restoration of shear forces and endothelial function and on the preservation of the endothelial‐glycocalyx barrier. John Wiley and Sons Inc. 2020-09-19 2020-11 /pmc/articles/PMC7687012/ /pubmed/32951280 http://dx.doi.org/10.1111/jcmm.15895 Text en © 2020 The Authors. Journal of Cellular and Molecular Medicine published by Foundation for Cellular and Molecular Medicine and John Wiley & Sons Ltd This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Reviews Lupu, Florea Kinasewitz, Gary Dormer, Kenneth The role of endothelial shear stress on haemodynamics, inflammation, coagulation and glycocalyx during sepsis |
title | The role of endothelial shear stress on haemodynamics, inflammation, coagulation and glycocalyx during sepsis |
title_full | The role of endothelial shear stress on haemodynamics, inflammation, coagulation and glycocalyx during sepsis |
title_fullStr | The role of endothelial shear stress on haemodynamics, inflammation, coagulation and glycocalyx during sepsis |
title_full_unstemmed | The role of endothelial shear stress on haemodynamics, inflammation, coagulation and glycocalyx during sepsis |
title_short | The role of endothelial shear stress on haemodynamics, inflammation, coagulation and glycocalyx during sepsis |
title_sort | role of endothelial shear stress on haemodynamics, inflammation, coagulation and glycocalyx during sepsis |
topic | Reviews |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7687012/ https://www.ncbi.nlm.nih.gov/pubmed/32951280 http://dx.doi.org/10.1111/jcmm.15895 |
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