title: Vascular adhesion protein-1 and syndecan-1 in septic shock.
abstract: BACKGROUND
  Constituents of vascular endothelial surface layer (glycocalyx), e.g. an anchor protein syndecan-1 (SDC-1), can be detected in plasma in many inflammatory conditions. In inflammation, vascular adhesion protein-1 (VAP-1) is rapidly translocated to the apical side of the endothelial cells and may be released to plasma in a soluble form. We hypothesized that glycocalyx injury coincides with VAP-1 activation on endothelial cells. To test the hypothesis, we measured SDC-1 and VAP-1 levels in 20 patients with septic shock.
  
  
  METHODS
  A prospective observational study was conducted in two multidisciplinary critical care units in two tertiary academic teaching hospitals with 20 mechanically ventilated adult patients with septic shock, on days 1 and 4 of treatment. Twenty healthy adults were enrolled as a control group. Plasma SDC-1 content, serum VAP-1 activity, platelets, and leukocyte count were measured in septic shock group at baseline and at 72 h and compared with those of healthy controls.
  
  
  RESULTS
  VAP-1 activity and SDC-1 content were significantly increased in septic patients' group (P < 0.01) in comparison with controls. VAP-1 activity and SDC-1 content correlated positively to each other, and negatively to platelet count. In the septic shock group SDC-1 correlated on day 1 to SOFA score.
  
  
  CONCLUSIONS
  We found increased VAP-1 activity and SDC-1 content in critically ill patients with septic shock. Based on our results, the role of VAP-1 in shock pathogenesis should be studied with semicarbazide-sensitive amine oxidase activity blocking agents and substrate affinity testing.
authors.affiliation: Intensive Care Units, Division of Anaesthesia and Intensive Care Medicine, Helsinki University Hospital, Helsinki, Finland. marko.sallisalmi@hus.fi
authors.forename: M
authors.initials: M
authors.lastname: Sallisalmi
authors.forename: J
authors.initials: J
authors.lastname: Tenhunen
authors.forename: R
authors.initials: R
authors.lastname: Yang
authors.forename: N
authors.initials: N
authors.lastname: Oksala
authors.forename: V
authors.initials: V
authors.lastname: Pettilä
mesh_terms: D000328:Adult; D000368:Aged; D006631:Amine Oxidase (Copper-Containing) / Q000097:blood*; D015415:Biomarkers; D015815:Cell Adhesion Molecules / Q000097:blood*; D016638:Critical Illness; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D019276:Glycocalyx / Q000378:metabolism / Q000473:pathology; D006801:Humans; D007239:Infections / Q000150:complications; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011446:Prospective Studies; D012121:Respiration, Artificial; D012772:Shock, Septic / Q000097:blood*; D053668:Syndecan-1 / Q000097:blood*
chemical_list: D015415:Biomarkers; D015815:Cell Adhesion Molecules; D053668:Syndecan-1; C076668:AOC3 protein, human; D006631:Amine Oxidase (Copper-Containing)