title: Endocan, a new endothelial marker in human sepsis.
abstract: OBJECTIVE
  a) To evaluate in septic patients the blood levels of endocan, a circulating proteoglycan, which regulates leukocyte function-associated antigen-1/intercellular adhesion molecule-1 interactions in vitro; b) to determine whether endocan could be used as a diagnostic and prognostic marker in sepsis in the intensive care unit; and c) to study kinetics of endocan secretion by endothelial cells in vitro after stimulation by soluble mediators involved in sepsis.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  Intensive care unit of the University Hospitals of Lille, France, and Geneva, Switzerland.
  
  
  METHODS
  All patients admitted to the intensive care unit over a 6-month period with clinical evidence of severe sepsis or septic shock.
  
  
  METHODS
  None.
  
  
  RESULTS
  In vitro, we showed a sustained endocan secretion by endothelial cells after stimulation by lipopolysaccharide and tumor necrosis factor-alpha. Circulating levels of endocan measured in 63 patients admitted to the intensive care unit with sepsis were significantly elevated compared with 20 healthy donors and seven patients with systemic inflammatory response syndrome: 2.71 +/- 4.88 ng/mL vs. 0.77 +/- 0.44 ng/mL vs. 0.68 +/- 1.03 ng/mL (median +/- interquartile range, p < .001). Endocan levels were higher in patients with septic shock (6.11 +/- 12.99 ng/mL, n = 22) than in patients with severe sepsis (1.97 +/- 7.8 ng/mL, n = 12) or sepsis (1.95 +/- 1.63 ng/mL, n = 29). Measurement of endocan at intensive care unit admission revealed higher levels in nonsurvivors (n = 12) than in patients still alive 10 days later (n = 51, 6.98 +/- 13.8 vs. 2.45 +/- 4.09, p < .01).
  
  
  CONCLUSIONS
  These results suggest that in septic patients, endocan blood level is related to the severity of illness and the outcome of the patient and may represent a novel endothelial cell dysfunction marker.
authors.affiliation: INSERM Unit 416, Institut Pasteur de Lille, France. a-scherpereel@chru-lille.fr
authors.forename: Arnaud
authors.initials: A
authors.lastname: Scherpereel
authors.forename: Florence
authors.initials: F
authors.lastname: Depontieu
authors.forename: Bogdan
authors.initials: B
authors.lastname: Grigoriu
authors.forename: Béatrice
authors.initials: B
authors.lastname: Cavestri
authors.forename: Anne
authors.initials: A
authors.lastname: Tsicopoulos
authors.forename: Thibaut
authors.initials: T
authors.lastname: Gentina
authors.forename: Mercé
authors.initials: M
authors.lastname: Jourdain
authors.forename: Jerome
authors.initials: J
authors.lastname: Pugin
authors.forename: Andre-Bernard
authors.initials: AB
authors.lastname: Tonnel
authors.forename: Philippe
authors.initials: P
authors.lastname: Lassalle
mesh_terms: D015415:Biomarkers; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000097:blood*; D011379:Prognosis; D011509:Proteoglycans / Q000097:blood*; D018805:Sepsis / Q000097:blood* / Q000145:classification / Q000401:mortality; D012720:Severity of Illness Index; D012772:Shock, Septic / Q000097:blood* / Q000145:classification / Q000401:mortality
chemical_list: D015415:Biomarkers; C101134:ESM1 protein, human; D009363:Neoplasm Proteins; D011509:Proteoglycans