Bacterial Porins and Their Procoagulant Role: Implication in the Pathophysiology of Several Thrombotic Complications during Sepsis
Carmine Siniscalchi,
Alessandro Perrella,
Ugo Trama,
Francesca Futura Bernardi,
Egidio Imbalzano,
Giuseppe Camporese,
Vincenzo Russo,
Olga Scudiero,
Tiziana Meschi,
Pierpaolo Di Micco
Affiliations
Carmine Siniscalchi
Internal Medicine Unit, Department of Internal Medicine, University of Parma, 43100 Parma, Italy
Alessandro Perrella
UOC Emerging Infectious Disease and High Contagiousness, AORN dei Colli, P.O. Cotugno, 80131 Naples, Italy
Ugo Trama
UOD Politica del Farmaco e Dispositivi della DG per la Tutela della Salute SSR, Regione Campania, Via Santa Lucia, 80100 Napoli, Italy
Francesca Futura Bernardi
Department of Pharmacology, University of Campania “Luigi Vanvitelli”—Monaldi Hospital, Piazzale Ettore Ruggeri, 80131 Naples, Italy
Egidio Imbalzano
Department of Clinical and Experimental Medicine, University of Messina, 98100 Messina, Italy
Giuseppe Camporese
Department of Internal Medicine DIMED, Padua University Hospital, 35100 Padua, Italy
Vincenzo Russo
Cardiology Unit, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”—Monaldi Hospital, Piazzale Ettore Ruggeri, 80131 Naples, Italy
Olga Scudiero
Department of Molecular Medicine and Medical Biotechnology, University Federico II of Naples, 80131 Naples, Italy
Tiziana Meschi
Internal Medicine Unit, Department of Internal Medicine, University of Parma, 43100 Parma, Italy
Pierpaolo Di Micco
UOC Medicina Interna, AFO Medica, P.O. Santa Maria delle Grazie, ASL Napoli 2 Nord, Pozzuoli, 80078 Naples, Italy
The association between sepsis and thrombotic complications is still not well known. Different mechanisms have been shown to be involved in the sepsis-induced prothrombotic state, but clinical scenarios may differ. In this review, we have summarized the role that bacterial products such as porins and toxins can have in the induction of the prothrombotic state during sepsis and the interaction that they can have with each other. Furthermore, the above-mentioned mechanisms might be involved in the pattern of the clinical presentation of thrombotic events during bacterial sepsis, which would secondarily explain the association between sepsis and venous thromboembolism, the association between sepsis and disseminated intravascular coagulation, and the association between sepsis and microangiopathic venous thromboembolism.
