Abstract
To the Editor: Considering that there is now a consensus on the central role of tumor necrosis factor in the pathogenesis of septic shock, the study by van der Poll et al. (June 7 issue),1 in which normal subjects were administered tumor necrosis factor, is both timely and important. I agree with their deduction — based on the increased levels of the activation peptide of factor X and prothrombin fragment F1+2 — that the common coagulation pathway is probably activated initially by tissue factor. However, their conclusion that the intrinsic pathway, particularly the contact system, was not activated is.
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