Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Annals of Intensive Care
Published in: Annals of Intensive Care 1/2017

Open Access 01-12-2017 | Research

Endocan as an early biomarker of severity in patients with acute respiratory distress syndrome

Authors: Diego Orbegozo, Lokmane Rahmania, Marian Irazabal, Manuel Mendoza, Filippo Annoni, Daniel De Backer, Jacques Creteur, Jean-Louis Vincent

Published in: Annals of Intensive Care | Issue 1/2017

Login to get access

Abstract

Background

Plasma concentrations of endocan, a proteoglycan preferentially expressed in the pulmonary vasculature, may represent a biomarker of lung (dys)function. We sought to determine whether the measurement of plasma endocan levels early in the course of acute respiratory distress syndrome (ARDS) could help predict risk of death or of prolonged ventilation.

Methods

All patients present in the department of intensive care during a 150-day period were screened for ARDS (using the Berlin definition). Endocan concentrations were measured at the moment of ARDS diagnosis (T0) and the following morning (T1). We compared data from survivors and non-survivors and data from survivors with less than 10 days of ventilator support (good evolution) and those who died or needed more than 10 days of mechanical ventilation (poor evolution). Results are presented as numbers (percentages), mean ± standard deviation or medians (percentile 25–75).

Results

Ninety-six consecutive patients were included [median APACHE II score of 21 (17–27) and SOFA score of 9 (6–12), PaO2/FiO2 ratio 155 (113–206)]; 64 (67%) had sepsis and 51 (53%) were receiving norepinephrine. Non-survivors were older (66 ± 15 vs. 59 ± 18 years, p = 0.045) and had higher APACHE II scores [27 (22–30) vs. 20 (15–24), p < 0.001] and blood lactate concentrations at study inclusion [2.1 (1.3–4.0) vs. 1.5 (0.9–2.6) mmol/L, p = 0.024] than survivors, but PaO2/FiO2 ratios [150 (116–207) vs. 158 (110–206), p = 0.95] were similar in the two groups. Endocan concentrations on the day after ARDS diagnosis were significantly higher in patients with poor evolution than in those with good evolution [12.0 (6.8–18.6) vs. 7.2 (5.4–12.5), p < 0.01].

Conclusion

Blood endocan concentrations early in the evolution of ARDS may be a useful marker of disease severity.
Appendix
Available only for authorised users
Literature
1.
Bellani G, Laffey JG, Pham T, Fan E, Brochard L, Esteban A, et al. Epidemiology, patterns of care, and mortality for patients with acute respiratory distress syndrome in intensive care units in 50 countries. JAMA. 2016;315:788–800.CrossRefPubMed
2.
Maca J, Jor O, Holub M, Sklienka P, Bursa F, Burda M, et al. Past and present ARDS mortality rates: a systematic review. Respir Care. 2017;62:113–22.CrossRefPubMed
3.
Ranieri VM, Rubenfeld GD, Thompson BT, Ferguson ND, Caldwell E, Fan E, et al. Acute respiratory distress syndrome: the Berlin definition. JAMA. 2012;307:2526–33.PubMed
4.
Orfanos SE, Mavrommati I, Korovesi I, Roussos C. Pulmonary endothelium in acute lung injury: from basic science to the critically ill. Intensive Care Med. 2004;30:1702–14.CrossRefPubMed
5.
Orfanos SE, Armaganidis A, Glynos C, Psevdi E, Kaltsas P, Sarafidou P, et al. Pulmonary capillary endothelium-bound angiotensin-converting enzyme activity in acute lung injury. Circulation. 2000;102:2011–8.CrossRefPubMed
6.
Orbegozo Cortes D, Rahmania L, Irazabal M, Santacruz C, Fontana V, De Backer D, et al. Microvascular reactivity is altered early in patients with acute respiratory distress syndrome. Respir Res. 2016;17:59.CrossRefPubMedPubMedCentral
7.
Bull TM, Clark B, McFann K, Moss M. Pulmonary vascular dysfunction is associated with poor outcomes in patients with acute lung injury. Am J Respir Crit Care Med. 2010;182:1123–8.CrossRefPubMedPubMedCentral
8.
Moussa MD, Santonocito C, Fagnoul D, Donadello K, Pradier O, Gaussem P, et al. Evaluation of endothelial damage in sepsis-related ARDS using circulating endothelial cells. Intensive Care Med. 2015;41:231–8.CrossRefPubMed
9.
Lassalle P, Molet S, Janin A, Heyden JV, Tavernier J, Fiers W, et al. ESM-1 is a novel human endothelial cell-specific molecule expressed in lung and regulated by cytokines. J Biol Chem. 1996;271:20458–64.CrossRefPubMed
10.
Zhang SM, Zuo L, Zhou Q, Gui SY, Shi R, Wu Q, et al. Expression and distribution of endocan in human tissues. Biotech Histochem. 2012;87:172–8.CrossRefPubMed
11.
Palud A, Parmentier-Decrucq E, Pastre J, De Freitas CN, Lassalle P, Mathieu D. Evaluation of endothelial biomarkers as predictors of organ failures in septic shock patients. Cytokine. 2015;73:213–8.CrossRefPubMed
12.
Balta S, Mikhailidis DP, Demirkol S, Ozturk C, Celik T, Iyisoy A. Endocan: a novel inflammatory indicator in cardiovascular disease? Atherosclerosis. 2015;243:339–43.CrossRefPubMed
13.
14.
Thille AW, Esteban A, Fernandez-Segoviano P, Rodriguez JM, Aramburu JA, Vargas-Errazuriz P, et al. Chronology of histological lesions in acute respiratory distress syndrome with diffuse alveolar damage: a prospective cohort study of clinical autopsies. Lancet Respir Med. 2013;1:395–401.CrossRefPubMed
15.
Cox LA, van Eijk LT, Ramakers BP, Dorresteijn MJ, Gerretsen J, Kox M, et al. Inflammation-induced increases in plasma endocan levels are associated with endothelial dysfunction in humans in vivo. Shock. 2015;43:322–6.CrossRefPubMed
16.
Lee W, Ku SK, Kim SW, Bae JS. Endocan elicits severe vascular inflammatory responses in vitro and in vivo. J Cell Physiol. 2014;229:620–30.CrossRefPubMed
17.
Scherpereel A, Depontieu F, Grigoriu B, Cavestri B, Tsicopoulos A, Gentina T, et al. Endocan, a new endothelial marker in human sepsis. Crit Care Med. 2006;34:532–7.CrossRefPubMed
18.
Mihajlovic DM, Lendak DF, Brkic SV, Draskovic BG, Mitic GP, Novakov Mikic AS, et al. Endocan is useful biomarker of survival and severity in sepsis. Microvasc Res. 2014;93:92–7.CrossRefPubMed
19.
Tang L, Zhao Y, Wang D, Deng W, Li C, Li Q, et al. Endocan levels in peripheral blood predict outcomes of acute respiratory distress syndrome. Mediators Inflamm. 2014;2014:625180.PubMedPubMedCentral
20.
Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II: a severity of disease classification system. Crit Care Med. 1985;13:818–29.CrossRefPubMed
21.
Vincent JL, Moreno R, Takala J, Willatts S, De Mendonca A, Bruining H, et al. The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine. Intensive Care Med. 1996;22:707–10.CrossRefPubMed
22.
Mikkelsen ME, Shah CV, Scherpereel A, Lanken PN, Lassalle P, Bellamy SL, et al. Lower serum endocan levels are associated with the development of acute lung injury after major trauma. J Crit Care. 2012;27:522–7.CrossRefPubMed
23.
24.
Hernu R, Wallet F, Thiolliere F, Martin O, Richard JC, Schmitt Z, et al. An attempt to validate the modification of the American–European consensus definition of acute lung injury/acute respiratory distress syndrome by the Berlin definition in a university hospital. Intensive Care Med. 2013;39:2161–70.CrossRefPubMed
25.
Villar J, Perez-Mendez L, Basaldua S, Blanco J, Aguilar G, Toral D, et al. A risk tertiles model for predicting mortality in patients with acute respiratory distress syndrome: age, plateau pressure, and P(aO(2))/F(IO(2)) at ARDS onset can predict mortality. Respir Care. 2011;56:420–8.CrossRefPubMed
26.
Gajic O, Afessa B, Thompson BT, Frutos-Vivar F, Malinchoc M, Rubenfeld GD, et al. Prediction of death and prolonged mechanical ventilation in acute lung injury. Crit Care. 2007;11:R53.CrossRefPubMedPubMedCentral
27.
Su YH, Shu KH, Hu CP, Cheng CH, Wu MJ, Yu TM, et al. Serum endocan correlated with stage of chronic kidney disease and deterioration in renal transplant recipients. Transplant Proc. 2014;46:323–7.CrossRefPubMed
28.
Abid MR, Yi X, Yano K, Shih SC, Aird WC. Vascular endocan is preferentially expressed in tumor endothelium. Microvasc Res. 2006;72:136–45.CrossRefPubMed
29.
Scherpereel A, Gentina T, Grigoriu B, Senechal S, Janin A, Tsicopoulos A, et al. Overexpression of endocan induces tumor formation. Cancer Res. 2003;63:6084–9.PubMed
30.
Hatfield KJ, Lassalle P, Leiva RA, Lindas R, Wendelboe O, Bruserud O. Serum levels of endothelium-derived endocan are increased in patients with untreated acute myeloid leukemia. Hematology. 2011;16:351–6.CrossRefPubMed
31.
Ozaki K, Toshikuni N, George J, Minato T, Matsue Y, Arisawa T, et al. Serum endocan as a novel prognostic biomarker in patients with hepatocellular carcinoma. J Cancer. 2014;5:221–30.CrossRefPubMedPubMedCentral
32.
Grigoriu BD, Depontieu F, Scherpereel A, Gourcerol D, Devos P, Ouatas T, et al. Endocan expression and relationship with survival in human non-small cell lung cancer. Clin Cancer Res. 2006;12:4575–82.CrossRefPubMed
Metadata
Title
Endocan as an early biomarker of severity in patients with acute respiratory distress syndrome
Authors
Diego Orbegozo
Lokmane Rahmania
Marian Irazabal
Manuel Mendoza
Filippo Annoni
Daniel De Backer
Jacques Creteur
Jean-Louis Vincent
Publication date
01-12-2017
Publisher
Springer International Publishing
Published in
Annals of Intensive Care / Issue 1/2017
Electronic ISSN: 2110-5820
DOI
https://doi.org/10.1186/s13613-017-0311-4

Other articles of this Issue 1/2017

Annals of Intensive Care 1/2017 Go to the issue

Research

Etiologies, diagnostic work-up and outcomes of acute respiratory distress syndrome with no common risk factor: a prospective multicenter study

Research

Omega-3 supplementation in patients with sepsis: a systematic review and meta-analysis of randomized trials

Review

Immunohaemostasis: a new view on haemostasis during sepsis

Research

Implementation and evaluation of a paediatric nurse-driven sedation protocol in a paediatric intensive care unit

Research

Does metformin exposure before ICU stay have any impact on patients’ outcome? A retrospective cohort study of diabetic patients

Research

Associations among left ventricular systolic function, tachycardia, and cardiac preload in septic patients