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Evolving role of tissue factor and its pathway inhibitor
Sagar N Doshi1, Jonathan D Marmur
1Cardiovascular Institute, Mount Sinai School of Medicine, New York, NY, USA.
Critical Care Medicine
|May 11, 2002
Summary
Tissue factor initiates blood clots, with new evidence showing it exists in the blood. Tissue factor pathway inhibitor shows promise for treating thrombosis, though a recent sepsis trial was unsuccessful.
Area of Science:
- Hematology
- Vascular Biology
- Pharmacology
Background:
- Tissue factor initiates the extrinsic clotting cascade, a primary in vivo coagulation pathway.
- Traditionally, tissue factor was considered extravascular, but it's now found in plasma, microparticles, and leukocytes.
- Tissue factor also acts as a signaling receptor, expanding its known functions.
Purpose of the Study:
- To review evidence on tissue factor's role in intravascular thrombosis.
- To examine the potential of tissue factor pathway inhibitor as an antithrombotic therapy.
Main Methods:
- A PubMed search was conducted for English-language articles.
- Keywords included "tissue factor" and "tissue factor pathway inhibitor" in relation to intravascular coagulation.
Main Results:
- Tissue factor is the initiator of the extrinsic clotting cascade.
- Blood-borne tissue factor has a potential procoagulant function.
- Recombinant tissue factor pathway inhibitor inhibits experimental thrombus formation.
Conclusions:
- The tissue factor pathway initiates thrombosis.
- While a sepsis trial failed, tissue factor pathway inhibitor warrants further study for conditions like acute coronary syndromes.