Abstract
One of the main players in the severity of sepsis is the endothelium integrity. Endocan, also called endothelial cell-specific molecule-1 (ESM-1), was shown to be preferentially expressed in lung vasculature. Structurally, endocan/ESM-1 is a 50 kDa proteoglycan that can interact with ICAM-1 and LFA-1 integrins and consequently prevents inflammatory events. In an experimental rat endotoxemic shock model, we previously showed that a decrease in the leukocyte-endothelial cell contacts (induced by drugs) is clearly linked to an increase of blood endocan levels. Blood levels of endocan/ESM-1 were also shown to be associated with the severity and evolution of septic states in preliminary studies.
Highlights
In 2002, the Surviving Sepsis Campaign defined a strategy that aimed to reduce the high mortality due to sepsis
For example at 5 μg/ml LPS, the expression of GIPR was reduced to 86% and INSR 72% of control in U937: while in HUH7 cells at 1 μg/ml LPS, the GIPR expression was decreased to 63%, GLP-1R 95% and INSR 89% compared with control (P
As a result of this study we have developed a standardized sepsis protocol to integrate into the AE triage pro forma, as well as a pathway to help instigate treatment earlier to those patients identified as septic on the wards
Summary
In 2002, the Surviving Sepsis Campaign defined a strategy that aimed to reduce the high mortality due to sepsis. Patients admitted to ICUs with severe sepsis have a 39.8% risk of death [2], and for each hour delay in antibiotic administration, a 7.6% increase in mortality [3]. The objective of the present study was to evaluate the impact of early fluid resuscitation on serial TNFα and IL-6 levels and its association with mortality in severe sepsis. Our laboratory has demonstrated in preliminary clinical studies among the various biomarkers of endothelial dysfunction that blood levels of endocan (ESM-1), a pulmonary vascular endothelial cell-specific molecule participating in the control of endothelial–leukocyte interactions, are associated with the severity and evolution of septic states. The objective, of our study was to predict the development of organ failure at 24 hours using only the data available from the first 4 hours post inoculation Methods This pneumonia-sepsis model included 19 sheep with ALI. The sera were analyzed through serological (IgM and IgG specific ELISA) and molecular (gel-based and real-time RT-PCR) testing
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