ABSTRACT
This chapter summarises the observations of changes in the fibrinolytic system in humans following endotoxin administration. The administration of endotoxin to humans elicits a variety of acute inflammatory responses that are qualitatively similar to those that occur during the early stages of clinical sepsis. Sepsis is a syndrome initiated by a nidus of infection and often accompanied by bloodstream invasion by microorganisms. Bacterial components, including endotoxin, have been administered to humans during the past century for reasons as varied as therapy for malignancies or hypertension. The fibrinolytic response that is observed within hours of the administration of endotoxin or tumor necrosis factor is short lived and is followed by a change in the balance of coagulation and fibrinolysis in favor of a procoagulant state, manifested in part by the rise in plasminogen activator inhibitor-1. The role of whole bacteria in alterations of coagulation and fibrinolysis has been evaluated in primates given sublethal or lethal infusions of Escherichia coli.
