Tissue Factor in Trauma and Organ Dysfunction

ABSTRACT

Tissue factor (TF) performs an essential role in the blood clotting system by activating the extrinsic coagulation pathway following vascular injury. In addition to this physiological hemostatic role for wound repair, TF also plays pivotal roles in organ dysfunction in trauma patients by triggering pathological disseminated thrombosis and inflammation. Constitutively expressed TF in subendothelial cells is released into the circulation following trauma and can be detected as slightly elevated TF levels in the plasma. Liberation of constitutive TF into the blood and inducible tissue factor expression on monocytes and the other cells may synergistically increase plasma TF levels to higher values at the early stage of posttrauma, especially in patients with disseminated intravascular coagulation (DIC) in association with sustained systemic inflammatory response syndrome. Marked TF generation not adequately balanced by physiological coagulation inhibitors such as tissue factor pathway inhibitor in posttrauma DIC patients has been observed. Based on these pieces of evidence, it has now been accepted that combined activation of TF-dependent coagulation inadequately regulated by anticoagulant mechanisms and inflammation may synergistically play important roles in the pathogenesis of posttrauma multiple organ dysfunction syndrome.

KEYWORDS

Trauma - tissue factor - disseminated intravascular coagulation (DIC) - systemic inflammatory response syndrome (SIRS) - multiple organ dysfunction syndrome (MODS)

REFERENCES

• 1 Morrissey J H. Tissue factor: a key molecule in hemostatic and nonhemostatic systems.  Int J Hematol. 2004;  79 103-108
• 2 Østerud B. Tissue factor: a complex biological role.  Thromb Haemost. 1997;  78 755-758
• 3 Levi M, Keller T T, van Gorp E, ten Cate H. Infection and inflammation and the coagulation system.  Cardiovasc Res. 2003;  60 26-39
• 4 Østerud B, Bjørklid E. The tissue factor pathway in disseminated intravascular coagulation.  Semin Thromb Hemost. 2001;  27 605-617
• 5 Members of American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference Committee . American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference: definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis.  Crit Care Med. 1992;  20 864-874
• 6 Gando S, Kameue T, Nanzaki S, Nakanishi Y. Disseminated intravascular coagulation is a frequent complication of systemic inflammatory response syndrome.  Thromb Haemost. 1996;  75 224-228
• 7 Riewald M, Ruf W. Orchestration of coagulation protease signaling by tissue factor.  Trends Cardiovasc Med. 2002;  12 149-154
• 8 Gando S. Disseminated intravascular coagulation in trauma patients.  Semin Thromb Hemost. 2001;  27 585-592
• 9 Gando S, Kameue T, Nanzaki S et al.. Participation of tissue factor and thrombin in posttraumatic systemic inflammatory syndrome.  Crit Care Med. 1997;  25 1820-1826
• 10 Gando S, Nanzaki S, Sasaki S, Kemmotsu O. Significant correlations between tissue factor and thrombin markers in trauma and septic patients with disseminated intravascular coagulation.  Thromb Haemost. 1998;  79 1111-1115
• 11 Gando S, Nanzaki S, Morimoto Y et al.. Tissue factor pathway inhibitor response does not correlate with tissue factor-induced disseminated intravascular coagulation and multiple organ dysfunction syndrome in trauma patients.  Crit Care Med. 2001;  29 262-266
• 12 Münster A MB, Jensen J I, Bech B, Gram J. Activation of blood coagulation in pigs following lower limb gunshot trauma.  Blood Coagul Fibrinolysis. 2001;  12 477-485
• 13 Semeraro N, Colucci M. Tissue factor in health and disease.  Thromb Haemost. 1997;  78 759-764
• 14 Editorial . Disseminated intravascular coagulation and head injury.  Lancet. 1982;  2 531
• 15 Review . Abnormal blood clotting after head injury.  Lancet. 1989;  2 957-958
• 16 Gando S, Nanzaki S, Kemmotsu O. Coagulofibrinolytic changes after isolated head injury are not different from those in trauma patients without head injury.  J Trauma. 1999;  46 1070-1077
• 17 Gando S, Nakanishi Y, Tedo I. Cytokines and plasminogen activator inhibitor-1 in posttrauma disseminated intravascular coagulation: relationship to multiple organ dysfunction syndrome.  Crit Care Med. 1995;  23 1835-1842
• 18 Gando S, Kameue T, Matsuda N et al.. Combined activation of coagulation and inflammation has an important role in multiple organ dysfunction and poor outcome after severe trauma.  Thromb Haemost. 2002;  88 943-949
• 19 Todoroki H, Nakamura S, Higure I et al.. Neutrophils express tissue factor in a monkey model of sepsis.  Surgery. 2000;  127 209-216
• 20 Nakamura S, Imamura T, Okamoto K. Tissue factor in neutrophils: yes.  J Thromb Haemost. 2004;  2 214-217
• 21 Østerud B. Tissue factor in neutrophils: no.  J Thromb Haemost. 2004;  2 218-220
• 22 Miller C L, Graziano C G, Lim R C, Chin M. Generation of tissue factor by patient monocyte: correlation to thromboembolic complication.  Thromb Haemost. 1981;  46 489-495
• 23 Utter G H, Owings J T, Jacoby R C et al.. Injury induces increased monocyte expression of tissue factor: factors associated with head injury attenuate the injury-related monocyte expression of tissue factor.  J Trauma. 2002;  52 1071-1077
• 24 Armstead V E, Minchenko A G, Scalla R, Lefer A M. Pulmonary tissue factor mRNA expression during murine traumatic shock: effect of p-selectin blockade.  Shock. 2001;  15 323-326
• 25 André P, Hartwell D, Hrachovinová I et al.. Procoagulant state resulting from high levels of soluble P-selectin in blood.  Proc Natl Acad Sci USA. 2000;  97 13835-13840
• 26 Moore F A, Sauaia A, Moor E E et al.. Postinjury multiple organ failure.  J Trauma. 1996;  40 501-512
• 27 Yao Y M, Redl H, Bahrami S, Schlag G. The inflammatory basis of trauma/shock-associated multiple organ failure.  Inflamm Res. 1998;  47 201-210
• 28 Taylor Jr F B, Chang A CK, Peer G T et al.. DEGR-Factor Xa blocks disseminated intravascular coagulation initiated by Escherichia coli without preventing shock and organ damage.  Blood. 1991;  78 364-368
• 29 Esmon C T. Inflammation and thrombosis.  J Thromb Haemost. 2003;  1 1343-1348
• 30 Taylor Jr F B. Tissue factor and thrombin in posttraumatic systemic inflammatory response syndrome.  Crit Care Med. 1997;  25 1774-1775
• 31 Gando S, Nanzaki S, Kemmotsu O. Disseminated intravascular coagulation and sustained systemic inflammatory response syndrome predict organ dysfunctions after trauma. Application of clinical decision analysis.  Ann Surg. 1999;  229 121-127
• 32 Idell S. Coagulation, fibrinolysis, and fibrin deposition in acute lung injury.  Crit Care Med. 2003;  31(suppl) S213-S220
• 33 Welty-Wolf K E, Carraway M S, Ortel T L, Piantadosi C A. Coagulation and inflammation in acute lung injury.  Thromb Haemost. 2002;  88 17-25
• 34 Gando S, Nanzaki S, Morimoto Y et al.. Systemic activation of tissue-factor dependent coagulation pathway in evolving acute respiratory distress syndrome in patients with trauma and sepsis.  J Trauma. 1999;  47 719-723
• 35 Gando S, Kameue T, Matsuda N et al.. Imbalances between the levels of tissue factor and tissue factor pathway inhibitors in ARDS patients.  Thromb Res. 2003;  109 119-124