Early plasma angiopoietin-2 is prognostic for ARDS and mortality among critically ill patients with sepsis.

Autor: Rosenberger CM; Human Pathophysiology and OMNI Reverse Translation, Genentech, Inc., 1 DNA Way, South San Francisco, CA, 94080, USA. rosenbc4@gene.com., Wick KD; Division of Pulmonary and Critical Care Medicine, University of California San Francisco, 505 Parnassus Ave, San Francisco, CA, USA.; Department of Internal Medicine, University of California, Davis, Davis, CA, USA., Zhuo H; Division of Pulmonary and Critical Care Medicine, University of California San Francisco, 505 Parnassus Ave, San Francisco, CA, USA., Wu N; Division of Pulmonary and Critical Care Medicine, University of California San Francisco, 505 Parnassus Ave, San Francisco, CA, USA., Chen Y; Division of Pulmonary and Critical Care Medicine, University of California San Francisco, 505 Parnassus Ave, San Francisco, CA, USA., Kapadia SB; Infectious Diseases, Genentech, Inc., 1 DNA Way, South San Francisco, CA, USA., Guimaraes A; Human Pathophysiology and OMNI Reverse Translation, Genentech, Inc., 1 DNA Way, South San Francisco, CA, 94080, USA., Chang D; Human Genetics, Genentech, Inc., 1 DNA Way, South San Francisco, CA, USA., Choy DF; Human Pathophysiology and OMNI Reverse Translation, Genentech, Inc., 1 DNA Way, South San Francisco, CA, 94080, USA., Chen H; Early Clinical Development, Genentech, Inc., 1 DNA Way, South San Francisco, CA, USA.; Krystal Biotech, Pittsburgh, PA, USA., Peck M; Early Clinical Development, Genentech, Inc., 1 DNA Way, South San Francisco, CA, USA., Sullivan KM; Division of Pulmonary and Critical Care Medicine, University of California San Francisco, 505 Parnassus Ave, San Francisco, CA, USA., Ke S; Division of Pulmonary and Critical Care Medicine, University of California San Francisco, 505 Parnassus Ave, San Francisco, CA, USA., Jauregui A; Division of Pulmonary and Critical Care Medicine, University of California San Francisco, 505 Parnassus Ave, San Francisco, CA, USA., Leligdowicz A; Division of Pulmonary and Critical Care Medicine, University of California San Francisco, 505 Parnassus Ave, San Francisco, CA, USA.; Department of Medicine, Division of Critical Care, Western University, London, ON, Canada., Sinha P; Division of Pulmonary and Critical Care Medicine, University of California San Francisco, 505 Parnassus Ave, San Francisco, CA, USA., Gomez AD; Division of Pulmonary and Critical Care Medicine, University of California San Francisco, 505 Parnassus Ave, San Francisco, CA, USA., Kangelaris KN; Division of Pulmonary and Critical Care Medicine, University of California San Francisco, 505 Parnassus Ave, San Francisco, CA, USA., Delucchi K; Division of Pulmonary and Critical Care Medicine, University of California San Francisco, 505 Parnassus Ave, San Francisco, CA, USA., Liu KD; Division of Pulmonary and Critical Care Medicine, University of California San Francisco, 505 Parnassus Ave, San Francisco, CA, USA., Calfee CS; Division of Pulmonary and Critical Care Medicine, University of California San Francisco, 505 Parnassus Ave, San Francisco, CA, USA., Matthay MA; Division of Pulmonary and Critical Care Medicine, University of California San Francisco, 505 Parnassus Ave, San Francisco, CA, USA., Hendrickson CM; Zuckerberg San Francisco General, Division of Pulmonary and Critical Care Medicine, University of California San Francisco, 1001 Potrero Ave, San Francisco, CA, 94110, USA. Carolyn.hendrickson@ucsf.edu.
Jazyk: angličtina
Zdroj: Critical care (London, England) [Crit Care] 2023 Jun 13; Vol. 27 (1), pp. 234. Date of Electronic Publication: 2023 Jun 13.
DOI: 10.1186/s13054-023-04525-3
Abstrakt: Angiopoietin-2 (Ang-2) is associated with vascular endothelial injury and permeability in the acute respiratory distress syndrome (ARDS) and sepsis. Elevated circulating Ang-2 levels may identify critically ill patients with distinct pathobiology amenable to targeted therapy. We hypothesized that plasma Ang-2 measured shortly after hospitalization among patients with sepsis would be associated with the development of ARDS and poor clinical outcomes. To test this hypothesis, we measured plasma Ang-2 in a cohort of 757 patients with sepsis, including 267 with ARDS, enrolled in the emergency department or early in their ICU course before the COVID-19 pandemic. Multivariable models were used to test the association of Ang-2 with the development of ARDS and 30-day morality. We found that early plasma Ang-2 in sepsis was associated with higher baseline severity of illness, the development of ARDS, and mortality risk. The association between Ang-2 and mortality was strongest among patients with ARDS and sepsis as compared to those with sepsis alone (OR 1.81 vs. 1.52 per log Ang-2 increase). These findings might inform models testing patient risk prediction and strengthen the evidence for Ang-2 as an appealing biomarker for patient selection for novel therapeutic agents to target vascular injury in sepsis and ARDS.
(© 2023. The Author(s).)
Databáze: MEDLINE
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