title: Ratio of angiopoietin-2 to angiopoietin-1 predicts mortality in acute lung injury induced by paraquat.
abstract: BACKGROUND
  To determine whether initial reactive oxygen species (ROS)-induced endothelial cell injury is involved in early death after paraquat intoxication and concentrations of angiopoietin-1 (Ang-1), angiopoietin-2 (Ang-2), and von Willebrand factor (VWF) reflecting endothelial cell injury, we investigated the initial endothelial cell injury marker involved in the pathogenesis of death within 5 days after paraquat ingestion.
  
  
  METHODS
  Sixty patients with paraquat poisoning were prospectively enrolled. Plasma samples were collected at admission. Plasma concentrations of Ang-1, Ang-2, and VWF were measured by enzyme-linked immunosorbent assay. The patients were classified into 3 categories: survivors, early death (died within 5 days after ingestion), and late death (died more than 5 days after ingestion).
  
  
  RESULTS
  The baseline concentration of Ang-2 and the Ang-2: Ang-1 ratio were significantly higher in patients who died (Ang-2 [pg/mL], 1012.75 ± 468.02 vs. 1986.07 ± 1675.37 [p=0.002]; Ang-2: Ang-1, 0.90 ± 0.49 vs. 2.16 ± 2.28 [p=0.002]). The Ang-2: Ang-1 ratio was significantly higher in the early death group (2.41 ± 2.54) than in the survivors (0.90 ± 0.49) and the late death group (1.33 ± 0.64). The Ang-2: Ang-1 ratio was significantly associated with early death (OR, 2.602; 95% CI, 1.106-6.117; p=0.028) after adjusting for plasma levels of paraquat, age, PCO2, and creatinine. VWF did not predict mortality.
  
  
  CONCLUSIONS
  Endothelial cell damage could be involved in the pathogenesis of early death following paraquat ingestion.
authors.affiliation: Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
authors.forename: Jae-Sung
authors.initials: JS
authors.lastname: Choi
authors.forename: Kyung-A
authors.initials: KA
authors.lastname: Kwak
authors.forename: Min-Ju
authors.initials: MJ
authors.lastname: Park
authors.forename: Young-Hee
authors.initials: YH
authors.lastname: Kim
authors.forename: Hyo-Wook
authors.initials: HW
authors.lastname: Gil
authors.forename: Ho-Yeon
authors.initials: HY
authors.lastname: Song
authors.forename: Sae-Yong
authors.initials: SY
authors.lastname: Hong
mesh_terms: D055371:Acute Lung Injury / Q000097:blood* / Q000401:mortality*; D042683:Angiopoietin-1 / Q000097:blood*; D042702:Angiopoietin-2 / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010269:Paraquat / Q000506:poisoning*; D016019:Survival Analysis
chemical_list: D042683:Angiopoietin-1; D042702:Angiopoietin-2; D010269:Paraquat