005 Endocan, a potential new endothelial marker in human sepsis

Abstract

Resume Introduction We previously reported that serum levels of endocan, an endothelial derived dermatan sulphate proteoglycan which regulates LFA-1/ ICAM-1 interactions in vitro , are elevated in patients with sepsis. As the endothelium is an important player in sepsis, and endothelial activation parallel sepsis severity, we wonder if blood levels of endocan could be used as a diagnostic and prognostic marker in sepsis and how it compares with previously pro-posed markers as von Willebrand factor, IL6, IL 10, Procalcitonin or C reactive protein. We also studied kinetics of endocan secretion by endothelial cells in vitro after stimulation by soluble mediators involved in sepsis. Material and methods Endocan values were quantified by an in house sandwich type ELISA. Commercial assays were used for procalcitonin, C reactive protein, IL10, IL6, von Willebrand Factor. Design Prospective observational study. Setting Intensive care unit (ICU) of the University Hospitals of Lille, France, and Geneva, Switzerland. Patients All patients admitted to the intensive care unit over a 6-month period with clinical evidence of sepsis. Interventions None. Measurements and main results In vitro , we showed a sustained endocan secretion by endothelial cells after stimulation by LPS and TNFα. Circulating levels of endocan measured in 63 patients admitted in ICU with sepsis were significantly elevated compared to 20 healthy donors and 7 SIRS patients: 2.71 ± 4.88 ng/ml vs 0.77 ± 0.44 ng/ml vs 0.68 ± 1.03 ng/ml (median ± interquartile range) (p Conclusions These results suggest that in septic patients, endocan blood level is related to the severity and to the outcome of the patients, and may represent a novel endothelial cell dysfunction marker.