Tumor necrosis factor-induced necrosis: a monocyte-mediated hypercoagulable effect.

The mechanisms by which tumor necrosis factor (TNF) exerts its necrotic effects are somewhat obscure. We hypothesize that TNF, by monocyte activation, produces the procoagulant tissue factor, thus leading to a state of hypercoagulability with resultant thrombotic vascular occlusion and tissue necrosis. To test this hypothesis, modified recalcification time values (in minutes +/- standard deviation) were obtained on aliquots of blood with A) 20 microL of albumin, B) 20 microL of saline containing endotoxin, and C) 20 microL of albumin with 450 units of TNF. No differences were noted if the samples were not incubated. We conclude that TNF, can cause tumor (tissue) necrosis, and since incubation is required, TNF alone (without monocyte activation) has no procoagulant activity.