Angiopoietin-2 associations with the underlying infection and sepsis severity.
Angiopoietin-2 (Ang-2) is an important mediator in sepsis. We have previously shown that endotoxemia levels are related to the underlying infection and affect septic patients' outcome. Based on this background we now investigated if circulating Ang-2 (cAng-2) and monocyte Ang-2 expression in septic patients are associated with the underlying infection and organ failure. We measured cAng-2 in 288 septic patients (121 with sepsis, 167 with severe sepsis/septic shock) at less than 24h post study inclusion (day 1) and on days 3 and 7. Peripheral blood mononuclear cells (PBMCs) were additionally isolated; Ang-2 gene expression was estimated by means of real-time PCR. Levels of cAng-2 were higher under severe sepsis and septic shock, as compared to uncomplicated sepsis; PBMC Ang-2 copies were higher in severe sepsis. On day 1, cAng-2 and Ang-2 gene copies were greater under severe sepsis/septic shock in sufferers from all types of infections with the exception of community-acquired pneumonia and ventilator-associated pneumonia. cAng-2 increased proportionally to the number of failing organs, and was higher under metabolic acidosis and acute coagulopathy as compared to no failing organ. On day 1, copies of Ang-2 were higher in survivors, whereas cAng-2 was higher in non-survivors. In a large cohort of septic patients, cAng-2 kinetics appears associated with the underlying infection and organ failure type.
2nd Department of Medicine, Sismanogleion General Hospital, Athens, Greece. Electronic address: korinal@yahoo.com.
Korina
K
Lymperopoulou
Department of Medicine, Patras University Hospital, Patras, Greece.
Dimitrios
D
Velissaris
4th Department of Internal Medicine, University of Athens Medical School, Athens, Greece.
Antigone
A
Kotsaki
Intensive Care Unit, "G. Gennimatas" General Hospital, Thessaloniki, Greece.
Elli
E
Antypa
Department of Medicine, University of Thessaly, Medical School, Larissa, Greece.
Sara
S
Georgiadou
4th Department of Internal Medicine, University of Athens Medical School, Athens, Greece.
Thomas
T
Tsaganos
2nd Department of Critical Care Medicine, University of Athens, Medical School, Athens, Greece.
Despina
D
Koulenti
Intensive Care Unit, Korgialeneion Benaleion General Hospital, Athens, Greece.
Evgenia
E
Paggalou
4th Department of Internal Medicine, University of Athens Medical School, Athens, Greece.
Georgia
G
Damoraki
3rd Department of Pulmonary Medicine, Sismanogleion General Hospital, Athens, Greece.
Napoleon
N
Karagiannidis
2nd Department of Critical Care Medicine, University of Athens, Medical School, Athens, Greece.
Stylianos E
SE
Orfanos
D000368:Aged; D042683:Angiopoietin-1 / Q000097:blood; D042702:Angiopoietin-2 / Q000097:blood* / Q000235:genetics; D005260:Female; D018628:Gene Dosage; D006801:Humans; D007963:Leukocytes, Mononuclear / Q000378:metabolism; D008070:Lipopolysaccharides; D008297:Male; D008875:Middle Aged; D009928:Organ Specificity; D018805:Sepsis / Q000097:blood* / Q000382:microbiology*
D042683:Angiopoietin-1; D042702:Angiopoietin-2; D008070:Lipopolysaccharides
Angiopoietin-2; Infection; Organ failure; Sepsis