Endocan, a new endothelial marker in human sepsis.
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.
Scherpereel
Arnaud
A
INSERM Unit 416, Institut Pasteur de Lille, France. a-scherpereel@chru-lille.fr
Depontieu
Florence
F
Grigoriu
Bogdan
B
Cavestri
Béatrice
B
Tsicopoulos
Anne
A
Gentina
Thibaut
T
Jourdain
Mercé
M
Pugin
Jerome
J
Tonnel
Andre-Bernard
AB
Lassalle
Philippe
P
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
D015415:Biomarkers; C101134:ESM1 protein, human; D009363:Neoplasm Proteins; D011509:Proteoglycans