title: Endothelium injury and inflammatory state during abdominal aortic aneurysm surgery: scrutinizing the very early and minute injurious effects using endothelial markers - a pilot study.
abstract: BACKGROUND
  One of the most severe complications of repair surgery for abdominal aortic aneurysms (AAA) is acute kidney injury (AKI). Acute kidney injury is an inflammatory process whose pathogenesis involves endothelial cells (EC). The aim of this study was to assess the dynamics of endothelium injury markers measured during elective AAA surgery which might confirm the inflammatory character of AKI.
  
  
  METHODS
  The study group consisted of 14 patients with AAA. We measured plasma soluble forms of intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), E-selectin, P-selectin as well as the levels of von Willebrand factor (vWF) before, during (including intra-abdominal vein levels before and after aortic clamp removal) and within 2 days after surgery.
  
  
  RESULTS
  We have found a biphasic response of ICAM-1, VCAM-1 and P-selectin with an initial fall and subsequent rise. However, only VCAM-1 changes were significant compared to its baseline value. The maximum decrease of VCAM-1 was observed in the renal vein 5 min after aortic clamp removal (335.42 ±129.63 ng/ml vs. 488.90 ±169.80 ng/ml baseline value, p < 0.05), and the highest rise 48 h after aortic clamp removal (721.46 ±333.99 vs. baseline, p < 0.05).
  
  
  CONCLUSIONS
  Vascular cell adhesion molecule-1 turned out to be the most sensitive indicator of EC injury and inflammatory status after AAA surgery. During AAA surgery, soluble forms of P-selectin, ICAM-1 and VCAM-1 demonstrate a biphasic response with an initial fall and subsequent rise. These soluble forms could have a modulatory effect on the development of inflammation.
authors.affiliation: Department of Internal Medicine and Metabolic Diseases, Medical University of Silesia, Katowice, Poland.
authors.forename: Michał
authors.initials: M
authors.lastname: Kokot
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Biolik
authors.forename: Damian
authors.initials: D
authors.lastname: Ziaja
authors.forename: Tadeusz
authors.initials: T
authors.lastname: Fojt
authors.forename: Kamila
authors.initials: K
authors.lastname: Cisak
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Antoniak
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Pawlicki
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Ziaja
authors.forename: Jan
authors.initials: J
authors.lastname: Duława
keywords: E-selectin; P-selectin; acute kidney injury; intercellular adhesion molecule-1; vascular cell adhesion molecule-1; von Willebrand factor