THBD and Sepsis: In addition to their role in controlling vasoconstriction/vasodilation and vascular permeability, endothelial cells are essential for maintaining the balance between coagulation and anticoagulation, and they play a prominent role in all three major pathogenic pathways associated with coagulopathy in sepsis: increased tissue factor-mediated thrombin generation; dysfunction of antithrombin and the thrombomodulin-protein C anticoagulant system; and blocked fibrinolysis, which is induced by increased plasminogen activator inhibitor-1 (PAI-1) expression.