FIGURE 3.

Inflammation-triggered coagulation and thrombosis in vasculature. Upon mechanical injury or systemic inflammation of the vessel wall, activated endothelial cells and monocytes release tissue factor (TF). TF induces the generation of activated forms of coagulation factors FVII, FX, and thrombin, leading to fibrin formation. Thrombin induces the release of P-selectin, which binds to P-selectin glycoprotein ligand-1 (PSGL-1) on neutrophils, monocytes and lymphocytes mediating their tethering and rolling on to the exposed endothelium. The release of procoagulant platelet factor 4 (PF4) and von Willebrand factor (VWF) promote the recruitment, adhesion, and activation of platelets and leukocytes at the injury site. Thrombin cleaves fibrinogen to form fibrin, which stabilizes thrombosis. The firm adhesion of leukocytes to fibrin occurs via CD11b/18 αMβ2, macrophage-1 antigen (MAC-1) or complement receptor 3 (CR3).