Coagulation, inflammation, and the risk of neonatal white matter damage

Pediatr Res. 2004 Apr;55(4):541-5. doi: 10.1203/01.PDR.0000121197.24154.82. Epub 2004 Feb 18.

Abstract

Indicators of coagulation activation are sometimes increased in the blood of newborns and adults who have a systemic inflammatory response. These coagulation factors have the ability to exacerbate inflammation, which in turn can promote coagulation. Therapies directed solely at coagulation factors and therapies directed solely at inflammation factors have not proved effective in reducing mortality in adults with a systemic inflammatory response syndrome and multi-organ dysfunction (SIRS/MOD). On the other hand, the only therapy that has reduced mortality in SIRS/MOD is activated protein C, which has both anti-coagulation and anti-inflammatory effects. This and other observations support the view that activated coagulation factors enhance inflammation. Since newborns at risk of cerebral white matter damage and cerebral palsy are more likely than their peers to have a systemic inflammatory response, which is sometimes accompanied by elevated blood levels of coagulation factors, we suggest that activated coagulation factors contribute to the occurrence of cerebral white matter damage by exacerbating inflammatory phenomena, rather than by occluding cerebral blood vessels.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Adult
  • Animals
  • Blood Coagulation Factors / immunology*
  • Blood Coagulation*
  • Cerebral Cortex / anatomy & histology
  • Cerebral Cortex / immunology
  • Cerebral Cortex / pathology*
  • Cerebral Palsy / etiology
  • Cerebral Palsy / immunology
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Inflammation*
  • Protein C / immunology
  • Respiratory Distress Syndrome, Newborn / immunology
  • Systemic Inflammatory Response Syndrome / immunology
  • Systemic Inflammatory Response Syndrome / mortality

Substances

  • Blood Coagulation Factors
  • Protein C