title: Soluble plasma VE-cadherin concentrations are elevated in patients with STEC infection and haemolytic uraemic syndrome: a case-control study.
abstract: OBJECTIVE
  To investigate whether the adherens junction protein vascular endothelial cadherin (VE-cadherin) is released during Shiga toxin 2 producing Escherichia coli (STEC) infection with haemolytic uraemic syndrome (HUS) and thus could be used to assist diagnosis.
  
  
  METHODS
  Using data from the large 2011 STEC outbreak in northern Europe, we determined VE-cadherin plasma concentrations in 356 patients distributed over three patient cohorts: patients with STEC infection accompanied by HUS (STEC-HUS), STEC patients without HUS (STEC) and control patients with diarrhoea but without STEC infection. We then looked for associations between VE-cadherin concentrations and disease severity defined by changes in lactate dehydrogenase, haemoglobin, creatinine, platelet count, haptoglobin and neurological symptoms.
  
  
  METHODS
  This study was conducted at the University Medical Center Hamburg-Eppendorf, Germany.
  
  
  METHODS
  79 STEC-HUS patients, 77 STEC patients and 200 control patients were enrolled in the study.
  
  
  RESULTS
  We analysed 864 specimens (207 STEC, 449 STEC-HUS and 208 controls) in total. At admission, VE-cadherin concentration tended to be lower in STEC-HUS patients compared to other patients. However, HUS patients later showed an increase in VE-cadherin concentrations with prolonged elevation beyond remission. This pattern clearly differs from that observed in non-HUS patients.
  
  
  CONCLUSIONS
  VE-cadherin concentrations are elevated in STEC-HUS patients and might be a biomarker reflecting endothelial damage in patients with HUS.
authors.affiliation: Department of Clinical Chemistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Julia
authors.identifier: http://orcid.org/0000-0002-0873-299X
authors.initials: J
authors.lastname: Doulgere
authors.affiliation: Department of Clinical Chemistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Otto
authors.affiliation: Department of Clinical Chemistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Maher
authors.initials: M
authors.lastname: Nassour
authors.affiliation: Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Gerrit
authors.identifier: http://orcid.org/0000-0002-2984-6515
authors.initials: G
authors.lastname: Wolters-Eisfeld
authors.affiliation: Department of Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Holger
authors.initials: H
authors.lastname: Rohde
authors.affiliation: Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Tim
authors.initials: T
authors.lastname: Magnus
authors.affiliation: Department of Clinical Chemistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Wagener
authors.affiliation: Department of Clinical Chemistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany Department of Clinical Chemistry, University Hospital Cologne, Cologne, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Streichert
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D015820:Cadherins / Q000097:blood*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003967:Diarrhea / Q000097:blood / Q000150:complications / Q000382:microbiology; D004196:Disease Outbreaks; D004730:Endothelium, Vascular / Q000378:metabolism* / Q000473:pathology; D004927:Escherichia coli Infections / Q000097:blood* / Q000150:complications / Q000382:microbiology; D005260:Female; D005858:Germany; D006463:Hemolytic-Uremic Syndrome / Q000097:blood* / Q000150:complications / Q000382:microbiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D022641:Shiga Toxin 2 / Q000009:adverse effects*; D054323:Shiga-Toxigenic Escherichia coli; D055815:Young Adult; D000099152:Cadherin 5
chemical_list: D015703:Antigens, CD; D015415:Biomarkers; D015820:Cadherins; D022641:Shiga Toxin 2; D000099152:Cadherin 5
keywords: ELISA; Endothelial Damage; STEC HUS; Shiga toxin 2; VE-cadherin