title: Endothelial markers are associated with pancreatic necrosis and overall prognosis in acute pancreatitis: A preliminary cohort study.
abstract: BACKGROUND
  Endothelial injury is believed to play an important role in the evolution of pancreatic microcirculatory dysfunction and pancreatic necrosis (PN) in patients with acute pancreatitis (AP). The aim of this study was to investigate the role of three endothelial markers (von Willebrand factor, vWF; E-selectin; endothelial protein C receptor, EPCR) in the early phase of AP, especially the relationship between endothelial markers and PN.
  
  
  METHODS
  From March 2015 to March 2016, 57 AP patients admitted within 72 h of symptom onset in our hospital were included for this study. Blood samples were taken on admission and the clinical characteristics and outcomes of these patients were recorded. The levels of vWF, E-selectin and EPCR were measured using ELISA for analysis and compared with other severity markers of AP.
  
  
  RESULTS
  All the three markers were significantly different in healthy control, mild, moderate and severe AP patients. Moreover, the endothelial markers, especially vWF, also showed significant difference in patients with different extent of PN, as well as those with or without MODS. Additionally, the levels of endothelial markers correlated well with other commonly used markers of AP severity.
  
  
  CONCLUSIONS
  Elevated endothelium-related mediators (vWF, E-selectin and EPCR) appear to participate in the development of PN and may be a potential indicator of overall prognosis. Our results may help clinicians better understand the pathophysiological process of the development of PN.
authors.affiliation: Surgical Intensive Care Unit (SICU), Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No.305 Zhongshan East Road, Nanjing, China.
authors.forename: Yizhe
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Surgical Intensive Care Unit (SICU), Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No.305 Zhongshan East Road, Nanjing, China. Electronic address: kkb9832@163.com.
authors.forename: Lu
authors.initials: L
authors.lastname: Ke
authors.affiliation: Surgical Intensive Care Unit (SICU), Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No.305 Zhongshan East Road, Nanjing, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Meng
authors.affiliation: Surgical Intensive Care Unit (SICU), Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No.305 Zhongshan East Road, Nanjing, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Yang
authors.affiliation: Surgical Intensive Care Unit (SICU), Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No.305 Zhongshan East Road, Nanjing, China.
authors.forename: Zhihui
authors.initials: Z
authors.lastname: Tong
authors.affiliation: Surgical Intensive Care Unit (SICU), Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No.305 Zhongshan East Road, Nanjing, China.
authors.forename: Yiyuan
authors.initials: Y
authors.lastname: Pan
authors.affiliation: Surgical Intensive Care Unit (SICU), Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No.305 Zhongshan East Road, Nanjing, China. Electronic address: njzy_pancrea@163.com.
authors.forename: Weiqin
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No.305 Zhongshan East Road, Nanjing, China.
authors.forename: Jieshou
authors.initials: J
authors.lastname: Li
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015703:Antigens, CD / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D019040:E-Selectin / Q000097:blood*; D000074283:Endothelial Protein C Receptor; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000097:blood / Q000175:diagnosis*; D019283:Pancreatitis, Acute Necrotizing / Q000097:blood / Q000175:diagnosis; D011379:Prognosis; D011956:Receptors, Cell Surface / Q000097:blood*; D012720:Severity of Illness Index; D055815:Young Adult; D014841:von Willebrand Factor / Q000378:metabolism*
chemical_list: D015703:Antigens, CD; D015415:Biomarkers; D019040:E-Selectin; D000074283:Endothelial Protein C Receptor; C478370:PROCR protein, human; D011956:Receptors, Cell Surface; C546936:SELE protein, human; D014841:von Willebrand Factor
keywords: Acute pancreatitis; E-selectin; Endothelial protein C receptor; Pancreatic necrosis; von Willebrand factor