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Detailed medical illustration of disseminated intravascular coagulation (DIC) within a blood vessel, showing cellular and molecular interactions like coagulation, NETs, and fibrin dissolution.

Eine disseminierte intravasale Gerinnung (DIC, aus dem Englischen übernommen: «disseminated intravascular coagulation») ist meist die Folge einer Exposition von Gewebefaktor gegenüber Blut. Das dann entstehende Übergewicht prokoagulanter Faktoren triggert eine vermehrte Thrombinbildung, die ihrerseits die plasmatische Gerinnungskaskade in Gang setzt, Thrombozyten aktiviert und zu einer disseminierten Bildung von zunächst Mikrothromben führt. Es kommt ausserdem zur Induktion endothelialer und leukozytärer zellulärer Reaktionen. Dies führt einerseits zur Bildung von «neutrophil extracellular traps» oder «NETs» (intrazelluläre Bestandteile inkl. freier DNA, die ihrerseits wieder gerinnungsaktivierend wirken); andererseits verursacht die Stimulation von Endothelzellen (durch Zytokine und gestörte mikrovaskuläre Durchblutung) die Freisetzung von Gewebe-Plasminogen-Aktivator (tPA) aus Endothelzellen. Wie bei einer Gesamtaktivierung des Gerinnungssystems zu erwarten wird also in der DIC auch der fibrinolytische Weg aktiviert. Das erklärt, warum im Rahmen einer DIC sowohl Blutungen wie auch Thrombosen auftreten können. Mehr sehen

#medical illustration #biology #science

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