The role of coagulation factor Ⅻ and neutrophil extracellular trap in sepsis complicated with disseminated intravascular coagulation and the research progress of traditional Chinese medicine intervention
10.3969/j.issn.1008-9691.2025.03.023
- VernacularTitle:凝血因子Ⅻ与中性粒细胞胞外诱捕网在脓毒症并发弥散性血管内凝血中的作用及中医药干预研究进展
- Author:
Zekun WEI
1
;
Yang LIU
;
Zhaokui DENG
;
Na ZHANG
;
Bolin WANG
;
Wenzhao ZHANG
;
Cunyang LI
;
Li KONG
;
Feihu ZHANG
Author Information
1. 山东中医药大学,山东 济南 250355
- Publication Type:Journal Article
- Keywords:
Sepsis;
Disseminated intravascular coagulation;
Coagulation factor Ⅻ;
Neutrophil extracellular trap;
Traditional Chinese medicine
- From:
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2025;32(3):373-376
- CountryChina
- Language:Chinese
-
Abstract:
Sepsis is a common critical illness in clinical practice,characterized by rapid progression and high mortality.Its complex pathogenesis remains a major focus and challenge in the field of critical care medicine.Disseminated intravascular coagulation(DIC)is one of the most frequent and severe complications of sepsis,featuring systemic activation of the coagulation cascade and microthrombus formation,significantly increasing the mortality.Coagulation factorⅫ(FⅫ),a serine protease,is considered to have therapeutic potential for thrombosis without impairing normal hemostasis.Study reveal that neutrophil extracellular trap(NET),web-like DNA structures released through a unique process known as NETosis,provide negatively charged scaffolds that promote FⅫ binding and activation,thus triggering the intrinsic coagulation cascade and contributing to a hypercoagulable state.In recent years,increasing attention has been paid to the interaction between NET and FⅫ in sepsis complicated with DIC.These 2 factors play central roles in intravascular thrombus formation and coagulation activation.Beyond their antimicrobial function,NET can aggravate tissue injury and coagulation abnormalities by releasing proinflammatory mediators such as myeloperoxidase(MPO),neutrophil elastase(NE),and reactive oxygen species(ROS).FⅫ activation can further trigger the kallikrein-kinin system(KKS)and activate FⅪ,amplifying inflammation and thrombosis in a vicious cycle.Traditional Chinese medicine(TCM),as a key component of Chinese medical heritage,has demonstrated unique advantages in managing sepsis and its complications.Based on therapeutic principles such as"strengthening healthy qi and eliminating pathogenic factors"and"tonifying qi and activating blood circulation",TCM is believed to regulate immune function and correct coagulation disorders,thereby interfering with the hypercoagulable state mediated by NET and FⅫ,slowing the progression of DIC,and improving clinical outcomes.Several herbs,including Salvia miltiorrhiza,Astragalus membranaceus,Rheum officinale,Ligusticum chuanxiong,and Curcuma longa,have shown anticoagulant,antiplatelet,and anti-inflammatory properties.In addition,compound formulations such as Xuebijing injection and Qingwen Baidu decoction have demonstrated clinical efficacy in improving coagulation parameters,reducing D-dimer levels,and protecting organ function.Although current evidence on the effects of TCM on NET formation and FⅫactivation is still limited,its potential mechanisms and clinical value warrant further investigation.This review summarizes the critical roles and interplay of FⅫand NET in sepsis complicated with DIC and discusses the advances in TCM-based interventions,aiming to provide new perspectives for mechanism-oriented research and integrative therapeutic strategies.
