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(Circulation Research. 2001;89:1.)
© 2001 American Heart Association, Inc.

Editorial

Tissue Factor, the Emerging Link Between Inflammation, Thrombosis, and Vascular Remodeling

Marc S. Penn, Eric J. Topol

From the Departments of Cardiology and Cell Biology, Cleveland Clinic Foundation, Cleveland, Ohio.

Correspondence to Marc S. Penn, MD, PhD, Departments of Cardiology and Cell Biology, Cleveland Clinic Foundation, NC10, 9500 Euclid Ave, Cleveland, OH 44915. E-mail pennm@ccf.org

Key Words: thrombosis • acute coronary syndrome • restenosis

Tissue factor (TF) is a cell surface protein that is expressed by endothelial cells, monocytes, and smooth muscle cells in response to a variety of stimuli including lipopolysaccharide,¹ growth factors,² and lipoproteins³ (Figure). The main function of TF is to bind coagulation factor VII, leading to activation of both the intrinsic and extrinsic blood coagulation cascades.⁴ In normal arteries, TF expression is limited to the adventitia except for sporadic expression in the media.⁵ Although TF is important in maintaining vascular integrity in response to injury, abnormal TF expression has broad-ranging importance in a variety of human diseases including disseminated intravascular coagulation in patients with sepsis⁶ and arterial thrombosis in patients with unstable angina.⁷

View larger version (24K): [in this window] [in a new window]   Figure 1. Schematic representation of the vascular wall showing the effects of agonists that increase TF expression, , on the cell surfaces of monocytes, smooth muscle cells (SMCs), and endothelial cells (ECs).

In this issue of Circulation Research, Singh et al⁸ further our understanding of the importance of TF in vascular disease by demonstrating the importance of TF expression on the development of neointimal growth in response to hemostasis. Previous studies using this model of carotid artery ligation leading to smooth muscle cell hyperplasia and neointimal formation⁹ have demonstrated the necessity of fibrin deposition for the smooth muscle cell migration and proliferation to occur.¹⁰

This study by Singh et al⁸ also furthers our understanding of the importance of TF in the generation of local fibrin deposition. They showed that in response to blood hemostasis, TF, but not . . . [Full Text of this Article]

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