P0604IDENTIFICATION OF NOVEL ENDOTHELIAL ACTIVATION BIOMARKERS IN PATIENTS WITH LEPTOSPIROSIS AND ITS ASSOCIATION WITH ACUTE KIDNEY INJURY

Abstract

Abstract Background and Aims Leptospirosis has a broad clinical spectrum. Many patients present a severe disease, with potentially fatal outcomes. Novel biomarkers of endothelial activation are being studied in order to predict the severity of disease and to establish early assistance to the patients. Method For the analysis of biomarkers, blood samples were collected at hospital admission, in proper material for serum isolation. Aliquots were frozen at -80 ºC until the analysis was done. To quantify the biomarkers, ELISA kits were used: Syndecan-1 (Abcam–ab47352), ICAM-1 (Abcam–ab47349) e VCAM-1 (Abcam–ab47355), Angiopoietin-2 (R&D Systems–Duoset DY623) e FGF-23 (R&D Systems–Duoset DY2604). Results A group of 27 patients was evaluated. 24 (88.9%) were males and 3 (11.1%) were females. Mean age was 39.1 ± 17.6 years. 14 (53.8%) required dialysis. Patients who required dialysis presented higher levels of syndecan-1 (572 [300-811] vs. 263 [106-421] ng/mL; p = 0.03), angiopoietin-2 (1.52 [0.72-2.72] vs. 0.63 [0.4-1.38] ng/mL; p = 0.01), and FGF-23 (291 [56-2,031] vs. 10 [10-806] pg/mL; p = 0.021). There were no significant differences in the levels of VCAM-1 and ICAM-1 between the two groups. Syndecan-1 showed significant correlation with the levels of creatinine at hospital admission (r = 0.546; p = 0.05) and total bilirubin at hospital admission (r = 0.534; p = 0.013). Angiopoietin-2 showed significant correlation with the levels of creatinine at hospital admission (r = 0.513; p = 0.009) and the number of hemodialysis sessions (r = 0.406; p = 0.049). No correlation was shown concerning FGF-23. Conclusion Novel biomarkers revealed leptospirosis-associated endothelial activation and were significantly increased in patients with renal involvement. Therefore, they may be useful for establishing early identification and assistance in those patients.