Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Lupu, Florea, Kinasewitz, Gary, Dormer, Kenneth
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
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
_version_ 1783613443925868544
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
work_keys_str_mv AT lupuflorea theroleofendothelialshearstressonhaemodynamicsinflammationcoagulationandglycocalyxduringsepsis
AT kinasewitzgary theroleofendothelialshearstressonhaemodynamicsinflammationcoagulationandglycocalyxduringsepsis
AT dormerkenneth theroleofendothelialshearstressonhaemodynamicsinflammationcoagulationandglycocalyxduringsepsis
AT lupuflorea roleofendothelialshearstressonhaemodynamicsinflammationcoagulationandglycocalyxduringsepsis
AT kinasewitzgary roleofendothelialshearstressonhaemodynamicsinflammationcoagulationandglycocalyxduringsepsis
AT dormerkenneth roleofendothelialshearstressonhaemodynamicsinflammationcoagulationandglycocalyxduringsepsis