| Therapeutic Modulation of Coagulation and Fibrinolysis in Acute Lung Injury and the Acute Respiratory Distress Syndrome. | |
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MedLine Citation:
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PMID: 21401517 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Acute respiratory distress syndrome (ARDS) and acute lung injury (ALI) are characterized by excessive intra-alveolar fibrin deposition, driven, at least in part by inflammation. The imbalance between activation of coagulation and inhibition of fibrinolysis in patients with ALI/ARDS favors fibrin formation and appears to occur both systemically and in the lung and airspace. Tissue factor (TF), a key mediator of the activation of coagulation in the lung, has been implicated in the pathogenesis of ALI/ARDS. As such, there have been numerous investigations modulating TF activity in a variety of experimental systems in order to develop new therapeutic strategies for ALI/ARDS. This review will summarize current understanding of the role of TF and other proteins of the coagulation cascade as well the fibrinolysis pathway in the development of ALI/ARDS with an emphasis on the pathways that are potential therapeutic targets. These include the TF pathway, the protein C pathway, antithrombin, heparin, and modulation of fibrinolysis through plasminogen activator-1 (PAI-1) or plasminogen activators (PA). Although experimental studies show promising results, clinical trials to date have proven unsuccessful in improving patient outcomes. Modulation of coagulation and fibrinolysis has complex effects on both hemostasis and inflammatory pathways and further studies are needed to develop new treatment strategies for patients with ALI/ARDS. |
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Authors:
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Sara C Sebag; Julie A Bastarache; Lorraine B Ware |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-3-14 |
Journal Detail:
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Title: Current pharmaceutical biotechnology Volume: - ISSN: 1873-4316 ISO Abbreviation: - Publication Date: 2011 Mar |
Date Detail:
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Created Date: 2011-3-15 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100960530 Medline TA: Curr Pharm Biotechnol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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T1218 MCN, 1161 21st Avenue S. Nashville, TN 37232-2650, USA. lorraine.ware@vanderbilt.edu. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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