Endothelial damage in septic shock patients as evidenced by circulating syndecan-1, sphingosine-1-phosphate and soluble VE-cadherin: a substudy of ALBIOS
| Autor: | Piotti, A., Novelli, D., Meessen, J. M. T. A., Ferlicca, D., Coppolecchia, S., Marino, A., Salati, G., Savioli, M., Grasselli, G., Bellani, G., Pesenti, A., Masson, S., Caironi, P., Gattinoni, L., Gobbi, M., Fracasso, C., Latini, R., Bruzzone, P., Pagan, F., Russo, R., Confalonieri, A., Abbruzzese, C., Vergnano, B., Faenza, S., Siniscalchi, A., Pierucci, E., Noto, A., Pezzi, A., Spanu, P., Parrini, V., Oggioni, R., Pasetti, G. S., Casadio, M. C., Buontempo, R., Carrer, S., Piccoli, F., Rizzi, T., Caricato, A., La Sala, M., Antonaci, A., Fassini, P., Paganini, S., Porta, V., Moise, G., Marell, S., Furia, M., Urbano, M. C., Carobbi, R., Poleni, S., Kandil, H., Ballotta, A., Bettini, F., Sanseverino, M., Gatta, A., Cecchini, F., Guatteri, L., Ciceri, G., Raimondi, F., Colombo, R., Ferraris, S., Borelli, M., Bellato, V., Cancellieri, F., Senni, S., Bertocchi, E., Ferri, P., Moioli, G., Fedele, A., Molin, A., Salsi, P., Brunori, E., Elisei, D., Maggio, G., Nicola, F. G., Cavana, M., Morelli, G., Guarino, A., Isetta, M., Tulli, G., Mangani, V., Rossi, N., Ferrari, M., Bona, F., Vay, M., Bartoli, T., Gallo, M., Vettoretto, K., Morte, M. D., Boselli, E., Puscio, D., Bovo, M., Galzerano, A., Carli, M., Zagara, G. |
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| Přispěvatelé: | Piotti, A, Novelli, D, Meessen, J, Ferlicca, D, Coppolecchia, S, Marino, A, Salati, G, Savioli, M, Grasselli, G, Bellani, G, Pesenti, A, Masson, S, Caironi, P, Gattinoni, L, Gobbi, M, Fracasso, C, Latini, R |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
Letter medicine.medical_treatment 030204 cardiovascular system & hematology Critical Care and Intensive Care Medicine Gastroenterology 0302 clinical medicine VE-cadherin Sphingosine Septic shock 80 and over Medicine Endothelial dysfunction Phosphorylation Aged 80 and over lcsh:Medical emergencies. Critical care. Intensive care. First aid Shock Biomarker Glycocalyx Sphingosine-1-phosphate Syndecan-1 Aged Antigens CD Biomarkers Cadherins Endothelium Female Humans Italy Lysophospholipids Middle Aged Retrospective Studies Shock Septic Extravasation 3. Good health CD Endothelial stem cell medicine.medical_specialty Sepsis 03 medical and health sciences Internal medicine Albumins Settore MED/41 - ANESTESIOLOGIA Renal replacement therapy Antigens business.industry Septic Research Albumin 030208 emergency & critical care medicine lcsh:RC86-88.9 medicine.disease business |
| Zdroj: | Critical Care Critical Care, Vol 25, Iss 1, Pp 1-12 (2021) |
| ISSN: | 1466-609X 1364-8535 |
| Popis: | Background Septic shock is characterized by breakdown of the endothelial glycocalyx and endothelial damage, contributing to fluid extravasation, organ failure and death. Albumin has shown benefit in septic shock patients. Our aims were: (1) to identify the relations between circulating levels of syndecan-1 (SYN-1), sphingosine-1-phosphate (S1P) (endothelial glycocalyx), and VE-cadherin (endothelial cell junctions), severity of the disease, and survival; (2) to evaluate the effects of albumin supplementation on endothelial dysfunction in patients with septic shock. Methods This was a retrospective analysis of a multicenter randomized clinical trial on albumin replacement in severe sepsis or septic shock (the Albumin Italian Outcome Sepsis Trial, ALBIOS). Concentrations of SYN-1, S1P, soluble VE-cadherin and other biomarkers were measured on days 1, 2 and 7 in 375 patients with septic shock surviving up to 7 days after randomization. Results Plasma concentrations of SYN-1 and VE-cadherin rose significantly over 7 days. SYN-1 and VE-cadherin were elevated in patients with organ failure, and S1P levels were lower. SYN-1 and VE-cadherin were independently associated with renal replacement therapy requirement during ICU stay, but only SYN-1 predicted its new occurrence. Both SYN-1 and S1P, but not VE-cadherin, predicted incident coagulation failure. Only SYN-1 independently predicted 90-day mortality. Albumin significantly reduced VE-cadherin, by 9.5% (p = 0.003) at all three time points. Conclusion Circulating components of the endothelial glycocalyx and of the endothelial cell junctions provide insights into severity and progression of septic shock, with special focus on incident coagulation and renal failure. Albumin supplementation lowered circulating VE-cadherin consistently over time. Clinical Trial Registration: ALBIOS ClinicalTrials.gov number NCT00707122. |
| Databáze: | OpenAIRE |
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