title: The endothelium, a protagonist in the pathophysiology of critical illness: focus on cellular markers.
abstract: The endotheliumis key in the pathophysiology of numerous diseases as a result of its precarious function in the regulation of tissue homeostasis. Therefore, its clinical evaluation providing diagnostic and prognostic markers, as well as its role as a therapeutic target, is the focus of intense research in patientswith severe illnesses. In the critically ill with sepsis and acute brain injury, the endothelium has a cardinal function in the development of organ failure and secondary ischemia, respectively. Cellular markers of endothelial function such as endothelial progenitor cells (EPC) and endothelialmicroparticles (EMP) are gaining interest as biomarkers due to their accessibility, although the lack of standardization of EPC and EMP detection remains a drawback for their routine clinical use. In this paper we will review data available on EPC, as a general marker of endothelial repair, and EMP as an equivalent of damage in critical illnesses, in particular sepsis and acute brain injury. Their determination has resulted in new insights into endothelial dysfunction in the critically ill. It remains speculative whether their determination might guide therapy in these devastating acute disorders in the near future.
authors.affiliation: Department of Critical Care Medicine, Antwerp University Hospital (UZA), University of Antwerp (UA), Wilrijkstraat 10, 2650 Edegem, Belgium ; Department of Internal Medicine, Antwerp University Hospital (UZA) and University of Antwerp (UA), Wilrijkstraat 10, 2650 Edegem, Belgium ; Laboratory of Cellular and Molecular Cardiology, Antwerp University Hospital (UZA), University of Antwerp (UA), Wilrijkstraat 10, 2650 Edegem, Belgium.
authors.forename: Sabrina H
authors.initials: SH
authors.lastname: van Ierssel
authors.affiliation: Department of Critical Care Medicine, Antwerp University Hospital (UZA), University of Antwerp (UA), Wilrijkstraat 10, 2650 Edegem, Belgium ; Department of Internal Medicine, Antwerp University Hospital (UZA) and University of Antwerp (UA), Wilrijkstraat 10, 2650 Edegem, Belgium.
authors.forename: Philippe G
authors.initials: PG
authors.lastname: Jorens
authors.affiliation: Laboratory of Cellular and Molecular Cardiology, Antwerp University Hospital (UZA), University of Antwerp (UA), Wilrijkstraat 10, 2650 Edegem, Belgium ; Department of Cardiology, Antwerp University Hospital (UZA), University of Antwerp (UA), Wilrijkstraat 10, 2650 Edegem, Belgium.
authors.forename: Emeline M
authors.initials: EM
authors.lastname: Van Craenenbroeck
authors.affiliation: Laboratory of Cellular and Molecular Cardiology, Antwerp University Hospital (UZA), University of Antwerp (UA), Wilrijkstraat 10, 2650 Edegem, Belgium ; Department of Cardiology, Antwerp University Hospital (UZA), University of Antwerp (UA), Wilrijkstraat 10, 2650 Edegem, Belgium.
authors.forename: Viviane M
authors.initials: VM
authors.lastname: Conraads
mesh_terms: D015415:Biomarkers; D001930:Brain Injuries; D002545:Brain Ischemia; D016638:Critical Illness; D042783:Endothelial Cells; D004727:Endothelium; D006801:Humans; D013234:Stem Cells
chemical_list: D015415:Biomarkers