What is the role of antithrombin in the pathophysiology of disseminated intravascular coagulation (DIC)?

Updated: Dec 06, 2020
  • Author: Marcel M Levi, MD; Chief Editor: Srikanth Nagalla, MBBS, MS, FACP  more...
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Answer

Low antithrombin levels in DIC are associated with increased mortality, particularly in patients with sepsis. [21] That low levels of antithrombin precede the clinical manifestation of sepsis in prospective studies suggests that antithrombin is indeed involved in the pathogenesis of this disease and associated organ dysfunction. [27]

In addition to the decrease in antithrombin, significant depression of the protein C system may occur. Protein C, along with protein S, also serves as a major anticoagulant compensatory mechanism. Under normal conditions, protein C is activated by thrombin when complexed on the endothelial cell surface with thrombomodulin. [16] Activated protein C combats coagulation via proteolytic cleavage of factors Va and VIIIa and proteolyzes PAR1 when bound to the endothelial cell protein C receptor (EPCR).


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