Inflammation and hemostasis

Infl ammation and haemostasis are interrelated pathophysiologic processes that considerably aff ect each other. In this bidirectional relationship, infl ammation leads to activation of the haemostatic system that in turn also considerably infl uences infl ammatory activity. Such, the haemostatic system acts in concert with the infl ammatory cascade creating an infl ammation-haemostasis cycle in which each activated process promotes the other and the two systems function in a positive feedback loop. The extensive crosstalk between immune and haemostatic systems occurs at level of all components of the haemostatic system including vascular endothelial cells, platelets, plasma coagulation cascade, physiologic anticoagulants and fi brinolytic activity. During infl ammatory response, infl ammatory mediators, in particular proinfl ammatory cytokines, play a central role in the eff ects on haemostatic system by triggering its disturbance in a number of mechanisms including endothelial cell dysfunction, increased platelet reactivity, activation of the plasma coagulation cascade, impaired function of physiologic anticoagulants and suppressed fi brinolytic activity.