Цитокіни та С-реактивний білок – триггери дисбалансу системи гемостазу при запаленні

Abstract

Recent studies have confirmed hypothesis about crucial role of cytokines and C-reactive protein (CRP) in progression of inflammation [2, 12, 16, 20]. Cytokines are pluripotent short-distant molecules that are synthesized by activated cells of immune system. They mediate intercellular communications as well as stimulation or inhibition of cell growth, their differentiation, functional activity and apoptosis, etc. [1, 16]. In cell culture inflammatory cytokines, especially tumor necrosis factor-α (TNF-α) and interleukin- 1β (IL-1β), are major mediators that can elicit changes in cell phenotype [4]. CRP has been evaluated as «gold marker» of inflammation [13] and predictor of various pathological states such as myocardial infarction, acute renal and cardiac insufficiency, acute coronary syndrome, sepsis, neoplasia of different localizations [16]. It has been proved experimentally that pro-inflammatory cytokines such IL-1β, IL-6, IL-12, IL-3, TNF-α realized their effects through direct stimulation of CRP expression [12, 14]. On the other hand, reaction of inflammation, accompanying appearance of foreign antigens in the organism (independently from their origin: whether these are bacteria and viruses, or self-cells malignization), often results in disorders of hemostasis system. Severe infections and inflammation almost invariably lead to hemostatic abnormalities, ranging from insignificant laboratory changes to severe disseminated intravascular coagulation (DIC) [8, 15, 17, 19]. Imbalance develops due to the extra activation of coagulation mechanisms with simultaneous regulation of anticoagulant pathways and suppression of fibrinolysis [7, 9, 18]. Nowadays, cytokines and CRP are considered as highly relevant factors which trigger both inflammation and hypercoagulation [19]. Nevertheless, mechanisms of the interplay between cytokines and CRP, triggering inflammation reaction and factors of haemostasis, are still unclear and require following investigations. The aim of our research was to study of proinflammatory and anti-inflammatory links of cytokines’ network and CRP concentration as well as parameters of hemostasis system in conditions of inflammation process.