Haemostasis and innate immunity–a complementary relationship: a review of the intricate relationship between coagulation and complement pathways

CB Keragala, DF Draxler, ZK McQuilten… - British journal of …, 2018 - Wiley Online Library
British journal of haematology, 2018Wiley Online Library
Coagulation and innate immunity are linked evolutionary processes that orchestrate the host
defence against invading pathogens and injury. The complement system is integral to innate
immunity and shares numerous interactions with components of the haemostatic pathway,
helping to maintain physiological equilibrium. The term 'immunothrombosis' was introduced
in 2013 to embrace this process, and has become an area of much recent interest. What is
less apparent in the literature however is an appreciation of the clinical manifestations of the …
Summary
Coagulation and innate immunity are linked evolutionary processes that orchestrate the host defence against invading pathogens and injury. The complement system is integral to innate immunity and shares numerous interactions with components of the haemostatic pathway, helping to maintain physiological equilibrium. The term ‘immunothrombosis’ was introduced in 2013 to embrace this process, and has become an area of much recent interest. What is less apparent in the literature however is an appreciation of the clinical manifestations of the coagulation‐complement interaction and the consequences of dysregulation of either system, as seen in many inflammatory and thrombotic disease states, such as sepsis, trauma, atherosclerosis, antiphospholipid syndrome (APS), paroxysmal nocturnal haemoglobinuria (PNH) and some thrombotic microangiopathies to name a few. The growing appreciation of this immunothrombotic phenomenon will foster the drive for novel therapies in these disease states, including anticoagulants as immunomodulators and targeted molecular therapies.
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