Next Article in Journal
Investigation of a Novel Salt Stress-Responsive Pathway Mediated by Arabidopsis DEAD-Box RNA Helicase Gene AtRH17 Using RNA-Seq Analysis
Next Article in Special Issue
Using Serum Amino Acids to Predict Traumatic Brain Injury: A Systematic Approach to Utilize Multiple Biomarkers
Previous Article in Journal
Mutation-Dependent Pathomechanisms Determine the Phenotype in the Bestrophinopathies
Previous Article in Special Issue
Integrative Analysis of Circulating Metabolite Profiles and Magnetic Resonance Imaging Metrics in Patients with Traumatic Brain Injury
 
 
Review

Does Complement-Mediated Hemostatic Disturbance Occur in Traumatic Brain Injury? A Literature Review and Observational Study Protocol

1
Department of Neurosurgery, Karolinska University Hospital, 171 76 Stockholm, Sweden
2
Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden
3
Department for Trauma and Orthopedic Surgery, Cologne-Merheim Medical Center (CMMC), University Witten/Herdecke, 58455 Cologne, Germany
4
Institute for Research in Operative Medicine, University Witten/Herdecke, 58455 Cologne, Germany
*
Author to whom correspondence should be addressed.
Int. J. Mol. Sci. 2020, 21(5), 1596; https://doi.org/10.3390/ijms21051596
Received: 9 January 2020 / Revised: 7 February 2020 / Accepted: 25 February 2020 / Published: 26 February 2020
Despite improvements in medical triage and tertiary care, traumatic brain injury (TBI) remains associated with significant morbidity and mortality. Almost two-thirds of patients with severe TBI develop some form of hemostatic disturbance, which contributes to poor outcome. In addition, the complement system, which is abundant in the healthy brain, undergoes significant intra- and extracranial amplification following TBI. Previously considered to be structurally similar but separate systems, evidence of an interaction between the complement and coagulation systems in non-TBI cohorts has accumulated, with the activation of one system amplifying the activation of the other, independent of their established pathways. However, it is not known whether this interaction exists in TBI. In this review we summarize the available literature on complement activation following TBI, and the crosstalk between the complement and coagulation systems. We demonstrate how the complement system interacts with the coagulation cascade by activating the intrinsic coagulation pathway and by bypassing the initial cascade and directly producing thrombin as well. This crosstalk also effects platelets, where evidence points to a relationship with the complement system on multiple levels, with complement anaphylatoxins being able to induce disproportionate platelet activation and adhesion. The complement system also stimulates thrombosis by inhibiting fibrinolysis and stimulating endothelial cells to release prothrombotic microparticles. These interactions see clinical relevance in several disorders where a deficiency in complement regulation seems to result in a prothrombotic clinical presentation. Finally, based on these observations, we present the outline of an observational cohort study that is currently under preparation and aimed at assessing how complement influences coagulation in patients with isolated TBI. View Full-Text
Keywords: traumatic brain injury; hemostasis; coagulation; coagulopathy; thrombosis; complement; inflammation traumatic brain injury; hemostasis; coagulation; coagulopathy; thrombosis; complement; inflammation
Show Figures

Figure 1

MDPI and ACS Style

Fletcher-Sandersjöö, A.; Maegele, M.; Bellander, B.-M. Does Complement-Mediated Hemostatic Disturbance Occur in Traumatic Brain Injury? A Literature Review and Observational Study Protocol. Int. J. Mol. Sci. 2020, 21, 1596. https://doi.org/10.3390/ijms21051596

AMA Style

Fletcher-Sandersjöö A, Maegele M, Bellander B-M. Does Complement-Mediated Hemostatic Disturbance Occur in Traumatic Brain Injury? A Literature Review and Observational Study Protocol. International Journal of Molecular Sciences. 2020; 21(5):1596. https://doi.org/10.3390/ijms21051596

Chicago/Turabian Style

Fletcher-Sandersjöö, Alexander, Marc Maegele, and Bo-Michael Bellander. 2020. "Does Complement-Mediated Hemostatic Disturbance Occur in Traumatic Brain Injury? A Literature Review and Observational Study Protocol" International Journal of Molecular Sciences 21, no. 5: 1596. https://doi.org/10.3390/ijms21051596

Find Other Styles
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Back to TopTop