Semin Thromb Hemost 2017; 43(01): 036-047
DOI: 10.1055/s-0036-1597292
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Gene Variations in the Protein C and Fibrinolytic Pathway: Relevance for Severity and Outcome in Pediatric Sepsis

Navin P. Boeddha
1   Intensive Care and Department of Pediatric Surgery, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
2   Division of Pediatric Infectious Diseases and Immunology, Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
,
Marieke Emonts
3   Department of Paediatric Infectious Diseases and Immunology, Great North Children's Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
4   Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
,
Marjon H. Cnossen
5   Division of Pediatric Hematology, Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
,
Moniek P. de Maat
6   Department of Hematology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
,
Frank W. Leebeek
6   Department of Hematology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
,
Gertjan J. Driessen
2   Division of Pediatric Infectious Diseases and Immunology, Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
,
Jan A. Hazelzet
7   Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Publikationsdatum:
15. Dezember 2016 (online)

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Abstract

The host response to infection involves complex interplays between inflammation, coagulation, and fibrinolysis. Deregulation of hemostasis and fibrinolysis are major causes of critical illness and important determinants of outcome in severe sepsis. The hemostatic responses to infection vary widely between individuals, and are in part explained by polymorphisms in genes responsible for the protein C and fibrinolytic pathway. This review gives an overview of genetic polymorphisms in the protein C and fibrinolytic pathway associated with susceptibility and severity of pediatric sepsis. In addition, genetic polymorphisms associated with adult sepsis and other pediatric thromboembolic disorders are discussed, as these polymorphisms might be candidates for future molecular genetic research in pediatric sepsis.

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