UCSF

It is with equal appreciation and enthusiasm that we have the opportunity to participate in these valuable scientific discussions with our respected colleagues Dr. Wada and Dr. Yamakawa, as we did with Dr. Gando and Dr. Otomo on their analogous disseminated-intravascular coagulation (DIC)-centric views of trauma-induced coagulopathy (TIC). We welcome and appreciate Drs Wada and Yamakawa’s expounded descriptions on their areas of their expertise specific to the critical thrombin-specific biologies. We find their additions valuable to the overall framing of the state of the science and controversies that exists in TIC investigations. However, we continue to support that it would be erroneous to continue to force an inflexible view of the complex biology of TIC, thereby failing to acknowledge the various competing mechanisms and mediators described throughout the literature, including the sometimes contradictory biomarker phenotypes that are ‘impaired’ in TIC. In addition, much of our following response to Drs Wada and Yamakawa’s letter will involve referring back to what was already addressed within the manuscript that appears to have been overlooked. However, of absolute importance, we would like to stress that TIC remains open science should therefore be regarded with open minds and without siloed opinions.