title: Evaluation of endothelial damage in sepsis-related ARDS using circulating endothelial cells.
abstract: OBJECTIVE
  Endothelial cell activation and dysfunction are involved in the pathophysiology of ARDS. Circulating endothelial cells (CECs) may be a useful marker of endothelial dysfunction and damage but have been poorly studied in ARDS. We hypothesized that the CEC count may be elevated in patients with sepsis-related ARDS compared to those with sepsis without ARDS.
  
  
  METHODS
  ARDS was defined according to the Berlin consensus definition. The study population included 17 patients with moderate or severe ARDS, 9 with mild ARDS, 13 with sepsis and no ARDS, 13 non-septic patients, and 12 healthy volunteers. Demographic, hemodynamic, and prognostic variables, including PaO(2)/FiO(2) ratio, 28-day survival, blood lactate, APACHE II, and SOFA score, were recorded. CECs were counted in arterial blood samples using the reference CD146 antibody-based immunomagnetic isolation and UEA1-FITC staining method. Measurements were performed 12-24 h after diagnosis of ARDS and repeated daily for 3 days.
  
  
  RESULTS
  The median day-1 CEC count was significantly higher in patients with moderate or severe ARDS than in mild ARDS or septic-control patients [27.2 (18.3-49.4) vs. 17.4 (11-24.5) cells/ml (p < 0.034), and 18.4 (9.1-31) cells/ml (p < 0.035), respectively]. All septic patients (with or without ARDS) had higher day-1 CEC counts than the non-septic patients [19.6 (14.2-30.6) vs. 10.8 (5.7-13.2) cells/ml, p = 0.002].
  
  
  CONCLUSIONS
  The day-1 CEC count was significantly higher in ARDS patients than in other critically ill patients, and in moderate or severe ARDS patients compared to those with milder disease, making it a potentially useful marker of ARDS severity.
authors.affiliation: Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles (ULB), 808 Route de Lennik, 1070, Brussels, Belgium.
authors.forename: Mouhamed Djahoum
authors.initials: MD
authors.lastname: Moussa
authors.forename: Cristina
authors.initials: C
authors.lastname: Santonocito
authors.forename: David
authors.initials: D
authors.lastname: Fagnoul
authors.forename: Katia
authors.initials: K
authors.lastname: Donadello
authors.forename: Olivier
authors.initials: O
authors.lastname: Pradier
authors.forename: Pascale
authors.initials: P
authors.lastname: Gaussem
authors.forename: Daniel
authors.initials: D
authors.lastname: De Backer
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Vincent
mesh_terms: D018806:APACHE; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D004452:Echocardiography; D042783:Endothelial Cells / Q000166:cytology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012128:Respiratory Distress Syndrome / Q000097:blood* / Q000209:etiology / Q000473:pathology; D018805:Sepsis / Q000097:blood / Q000150:complications*; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers