Innate immunity, coagulation and surgery.

ABSTRACT

Inflammation is the host's defense mechanism to infection or trauma including surgical procedures. In the clinic, non-infectious inflammation plays an important part in cardiology (e.g. Percutaneous transluminal coronary angioplasty, PTCA), intensive care medicine (e.g. polytrauma), cardiac (e.g. extracorporeal circulation) and vascular surgery (e.g. reperfusion injury). An imbalance of the inflammatory response can cause an acute condition like sepsis or long-term Cardiovascular disease (CVD), both of which are leading killers in the Western world. Alterations in coagulation, innate immunity and endothelial function represent key aspects in the mechanism of inflammation and are the link between the pathogenesis of these two diseases. Studying inflammatory pathways or targeting specific mediators during inflammation may help to develop strategies to improve the clinical outcome of patients undergoing major surgery, where postoperative inflammation plays a crucial role.