Role of extracellular vesicles in the development of sepsis-induced coagulopathy.
Role of extracellular vesicles in the development of sepsis-induced coagulopathy.
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细胞外囊泡在脓毒症诱导的凝血功能障碍发生发展中的作用
DOI：
10.1186/s40560-018-0340-6
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发表时间：
2018
影响因子：
7.1
通讯作者：
Ogura H
中科院分区：
文献类型：
--
作者：
Iba T;Ogura H
细胞外小泡(EVS)的研究进展引起了临床医生和脓毒症凝血障碍研究人员的极大兴趣。在这里，我们打算更新最新的知识和目前尚未解决的问题。分泌膜包膜囊泡包括凋亡体、胞外体、胞外体、微囊泡和微粒，统称为EVS。虽然这些囊泡的基本结构是相同的，即起源于质膜，但它们的特征因其表面结构和内部成分而显著不同。许多研究表明，在脓毒症期间，循环中的EV水平升高，表现出促炎和促凝血特性。已知这些EV在脓毒症的凝血障碍和器官功能障碍的发展中发挥重要作用。脓毒症患者的凝血功能障碍主要表现为凝血功能激活、抗凝系统紊乱和纤溶系统失衡。这些过程相互协作，促进弥散性血管内凝血(DIC)的发展，造成毁灭性的后果。作为这一发病机制的一部分，膜暴露的组织因子、磷脂酰丝氨酸和囊泡内含有的生物活性物质，如组蛋白、核小体和高迁移率族蛋白1，有助于DIC的发展。EV不仅自身上调促凝血系统，而且还通过将其促凝血特性转移到远处的靶细胞来传播促血栓活性。虽然促凝剂作用背后的基本概念，EVS在脓毒症诱导的凝血障碍发展中的作用已经开始被揭示，但对实际状况的了解还远远不能令人满意，主要是因为缺乏标准化的检测程序。本文介绍了近年来的研究进展和尚待解决的问题。最近的研究成功地阐明了EVS在脓毒症凝血功能紊乱过程中的重要作用。然而，今后的研究需要在术语、方法和评价方法方面进一步统一。
The advances of research on extracellular vesicles (EVs) are of particular interest to the clinicians as well as the researchers who are studying coagulation disorder in sepsis. Here, we intend to update the latest knowledge and currently unsolved problems that should be addressed. Secreted membrane-enclosed vesicles including apoptotic bodies, exosomes, ectosomes, microvesicles, and microparticles are generically called EVs. Though the basic structure of these vesicles is the same, i.e., originating from the plasma membrane, their characteristics differ significantly depending on their surface structures and interior components. Numerous studies have shown elevated levels of circulating EVs that exhibit proinflammatory and procoagulant properties during sepsis. These EVs are known to play important roles in the development of coagulation disorder and organ dysfunction in sepsis. Coagulation disorder in sepsis is characterized by activated coagulation, disrupted anticoagulant systems, and imbalanced fibrinolytic systems. These processes collaborate with one another and contribute to the development of disseminated intravascular coagulation (DIC), with devastating consequences. As part of this pathogenesis, the membrane-exposed tissue factor, phosphatidylserine and bioactive substances contained within the vesicles, such as histones, nucleosomes, and high-mobility group box 1, contribute to the development of DIC. EVs not only upregulate the procoagulant systems by themselves, but they also disseminate prothrombotic activities by transferring their procoagulant properties to distant target cells. Though the basic concept behind the role of procoagulant properties, EVs in the development of sepsis-induced coagulopathy has started to be unveiled, knowledge of the actual status is far from satisfactory, mainly because of the lack of standardized assay procedures. Recent advances and current problems that remain to be resolved are introduced in this review. The recent studies succeeded to elucidate the important roles of EVs in the progress of coagulation disorder in sepsis. However, further harmonization in terminology, methodology, and evaluation methods is required for future studies.
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DOI：
10.1016/j.bbadis.2015.08.010
发表时间：
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期刊：
Biochimica et biophysica acta
影响因子：
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DOI：
10.1161/atvbaha.110.218123
发表时间：
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