Activation of the contact-phase system on bacterial surfaces—a clue to serious complications in infe

Abstract

Fever, hypotension and bleeding disorders are common symptoms of sepsis and septic shock. The activation of the contact-phase system is thought to contribute to the development of these severe disease states by triggering proinflammatory and procoagulatory cascades; however, the underlying molecular mechanisms are obscure. Here we report that the components of the contact-phase system are assembled on the surface of Escherichia coli and Salmonella through their specific interactions with fibrous bacterial surface proteins, curli and fimbriae. As a consequence, the proinflammatory pathway is activated through the release of bradykinin, a potent inducer of fever, pain and hypotension. Absorption of contact-phase proteins and fibrinogen by bacterial surface proteins depletes relevant coagulation factors and causes a hypocoagulatory state. Thus, the complex interplay of microbe surface proteins and host contact-phase factors may contribute to the symptoms of sepsis and septic shock.

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Herwald, H., Mörgelin, M., Olsén, A. et al. Activation of the contact-phase system on bacterial surfaces—a clue to serious complications in infectious diseases. Nat Med 4, 298–302 (1998). https://doi.org/10.1038/nm0398-298

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