Plasma Endocan Levels Research Articles

P107 THE EFFECT OF MELDONIUM ON THE ENDOTHELIAL FUNCTION ASSESSED BY PLASMA ENDOCAN LEVEL IN PATIENTS WITH ESSENTIAL HYPERTENSION

Background and Objective: Endothelial dysfunction is one of the main findings in patients with arterial hypertension. It is associated with atherosclerosis initiation and progression. Lately, a soluble dermatan sulfate proteoglycan Endocan is used as a marker of endothelial dysfunction in patients with big variety of diseases. Hence, aim of our study was to assess effect of competitive inhibitor of carnitine-dependent fatty acid oxidation and promoter of anaerobic oxidation via the glycolytic pathway, Meldonium, on endothelial function in patients with arterial hypertension. Methods: 30 nonsmoker, non-obese male patients with stage II hypertension (ESH/ESC 2018) were involved in a study. 15 patients were put on recommended antihypertensive treatment plan and other 15 patients on conventional plus Meldoneum 1000 mg per day treatment for 3 months. Endocan level was tested before and after 3 months of treatment period. Hypertension was diagnosed as an average office blood pressure of three different visits equal or more than 140/90 mmHg. Written informed consent letters were obtained from all the participants. Results: Mean age and average blood pressure of study groups were not different between conventional and conventional plus Meldonium groups (48.6±6.94 vs 51.53±7.22 years old and 148/94 vs 151/95; P= NS for both). Initial plasma endocan level also was similar between the two groups (1.920±0.625 for Meldonium and 1.854±0.391 for conventional treatment; P=NS). In comparison with initial level, plasma endocan level significantly decreased after 3 months of treatment with conventional plus Meldonium treatment (1.920±0.625 vs 1.344±0.041; P<0.05). Statistically significant difference of endocan level change after 3 month of treatment with conventional antihypertensive agents was not observed (1.854±0.391 vs 1.75±0.649; P=NS). Conclusion: Obtained results indicate, that 1 g/day Meldonium on top of conventional guideline recommended antihypertensive regimen significantly improves endothelial function assessed via plasma endocan level. Further studies are needed to confirm these results on a bigger population samples.

Endocan, a novel glycoprotein with multiple biological activities, may play important roles in neurological diseases.

Endothelial cell specific-1 (ESM-1), also known as endocan, is a soluble dermatan sulfate proteoglycan that is mainly secreted by endothelial cells. Endocan is associated with tumorigenesis and cancer progression and is also related to cardiovascular disorders, autoimmune diseases, and sepsis. The phenylalanine-rich region and linear polysaccharide of endocan are necessary for the protein to exert its biological functions. Elevated plasma endocan levels reflect endothelial activation and dysfunction. In addition, endocan participates in complex inflammatory responses and proliferative processes. Here, we reviewed current research on endocan, elaborated the protein's structure and biological functions, and speculated on its possible clinical value in nervous system diseases. We conclude that endocan may be a glycoprotein that plays an important role in neurological disorders.

Changes in plasma endocan level are related to circulatory but not respiratory failure in critically ill patients with COVID-19

The aim of this prospective, observational study was to assess whether changes in the level of endocan, a marker of endothelial damage, may be an indicator of clinical deterioration and mortality in critically ill COVID-19 patients. Endocan and clinical parameters were evaluated in 40 patients with acute respiratory failure on days 1–5 after admission to the intensive care unit. Endocan levels were not related to the degree of respiratory failure, but to the presence of cardiovascular failure. In patients with cardiovascular failure, the level of endocan increased over the first 5 days (1.63, 2.50, 2.68, 2.77, 3.31 ng/mL, p = 0.016), while in patients without failure it decreased (1.51, 1.50, 1.56, 1.42, 1.13 ng/mL, p = 0.046). In addition, mortality was more than twice as high in patients with acute cardiovascular failure compared to those without failure (68% vs. 32%, p = 0.035). Baseline endocan levels were lower in viral than in bacterial infections (1.57 ng/mL vs. 5.25 ng/mL, p < 0.001), with a good discrimination between infections of different etiologies (AUC of 0.914, p < 0.001). In conclusion, endocan levels are associated with the occurrence of cardiovascular failure in COVID-19 and depend on the etiology of the infection, with higher values for bacterial than for viral sepsis.

Prognostic and Diagnostic Value of Endocan in Kidney Diseases.

Endocan, previously called endothelial cell-specific molecule-1, is a soluble proteoglycan that is predominantly expressed in vascular endothelial cells of the lungs and kidneys. It is upregulated by proinflammatory cytokines and plays a critical role in inflammatory, proliferative, and neovascularization processes. The utility of endocan as a biomarker in a wide spectrum of diseases is being increasingly acknowledged. In this review, we summarize the current evidence concerning the role of endocan in kidney diseases, with emphasis on its prognostic and diagnostic value. It seems that the determination of plasma endocan levels may provide useful prognostic information in many types of renal failure such as chronic kidney disease, IgA nephropathy, and diabetic nephropathy. Endocan could additionally improve the early diagnostic evaluation of acute kidney disease, chronic renal allograft injury, and acute rejection after kidney transplantation, thus contributing to endothelial cell injury monitoring in a timely manner.

Plasma Endocan as a Predictor of Cardiovascular Event in Patients with End-Stage Renal Disease on Hemodialysis.

Endocan, a potential biomarker of endothelial dysfunction, is associated with increased cardiovascular risk. We investigated the utility of plasma endocan for predicting cardiovascular risk in end-stage renal disease (ESRD) patients undergoing hemodialysis. Of the 452 patients in the K-cohort, 354 with available plasma endocan levels were enrolled. The correlation between plasma endocan levels and the clinical characteristics of a study population were analyzed. We divided patients into two groups, according to plasma endocan levels, and investigated the predictive value of endocan for the occurrence of cardiovascular events. In a multiple linear regression analysis, plasma endocan levels were positively correlated with previous cardiovascular events and negatively correlated with body mass index, albumin, and triglyceride. Patients with higher plasma endocan levels experienced more frequent cardiovascular events than those with lower plasma endocan levels (12.9% in the lower group vs. 22.7% in the higher group, p = 0.016). Cox proportional hazard models showed that higher plasma endocan levels were an independent predictor of cardiovascular events in ESRD patients on hemodialysis ((hazard ration) HR 1.949, 95% (confidence interval) CI 1.144–3.319, p = 0.014). Our results suggest that plasma endocan level might be a useful biomarker for predicting cardiovascular events in ESRD patients on hemodialysis.

Maternal plasma endocan levels in intrauterine growth restriction

Objectives Intrauterine growth restriction (IUGR) is diagnosed when the estimated fetal weight remains below the 10th percentile of gestational age based on pathological restriction of growth and/or accompanying Doppler abnormalities. Endothelial dysfunction is a common pathogenetic pathway underlying IUGR etiology. Endocan (ESM-1) is a novel marker of endothelial dysfunction and inflammation found in the maternal circulation. This study was designed to compare plasma endocan levels between pregnancies complicated with IUGR and a control group. Study design Forty-four pregnancies complicated with IUGR and 47 healthy pregnancies were included. Maternal plasma endocan levels were detected by ELISA. Parametric data was studied by Student’s t-test. Mann–Whitney U-test was used in analyzing non-parametric data. Categorical variables underwent chi-square test. ROC analysis was performed to define the cutoff value of endocan in detecting IUGR. Spearman correlation test was performed. Results Maternal plasma endocan level varied significantly between IUGR and healthy pregnancies and was 1.8 fold higher in the IUGR group (793.0 (IQR:544.4–1896.0) ng/L vs. 441.8 (IQR: 408.3–512.4) ng/L, p < .001). There was a weak negative correlation between endocan level and 5th and 10th minute APGAR Scores (r = −0.256; p = .015 and r = −0.215; p = .042, respectively), a weak positive correlation with umbilical artery pulsatility index, and a moderate negative correlation with cerebroplacental ratio (r = 0.394; p < .001 and r = −0.459; p < .001, respectively). Conclusions There was a significant difference between endocan levels of IUGR and healthy pregnancies. Further studies might be designed to investigate the performance of endocan in predicting neonatal outcomes for pregnancies complicated with IUGR.

Endothelial-Specific Molecule 1 (Endocan) as a Marker of Vascular Endothelial Regulation of Obesity-Associated Peripheral Polyneuropathy in the Non-Diabetic Obese Patients

Abstract Background: The increasing incidence of obesity and its co-morbid situations poses a great challenge to worldwide health. Obesity has numerous co-morbidities including airway illness, insulin resistance, type 2 diabetes, atherosclerosis, peripheral polyneuropathy (PN) and cancer. Endocan is a proteoglycan that could be used as a biomarker of endothelial dysfunction. Aim of Study: The current study aimed to investigate plasma endocan level in non-diabetic obese patients and to explore the association between circulatory endocan with the clinical and electrophysiological tests of PN in obese patients. Methods: This cross-sectional controlled study enrolled 170 obese patients and 100 control group. The obese group was sub-classified according to BMI (Body Mass Index) into three groups; all participants were subjected to a complete neurological examination. The motor nerve conduction study of [median nerve, ulnar nerve, and Common Peroneal Nerve (CPN)] and the sensory nerve conduction study of [median, ulnar and sural nerves] of all subjects were estimated. Blood sampling and biochemical analysis for parameters of metabolic syndrome (MetS) were done, in addition, Doppler evaluation of Carotid Intima Media Thickness (CIMT) using 0.9mm thickness as a cut-off point was used for identification of atherosclerosis. We measured plasma endocan by Enzyme-Linked Immunosorbent Assay (ELISA). Results: Obese patients with PN had statistically significant higher levels of plasma endocan (218.6±26.26) compared to obese patients without PN (135.5±21.6) and controls (13.1± 3.2). Plasma endocan level was positively correlated with Toronto Clinical Scoring System (TCSS) and negatively correlated with measures of electrophysiological tests; Motor Nerve Conduction Velocities (MNCV) of median, ulnar nerves, Sensory Nerve Conduction Velocities (SNCV) of median and ulnar nerves, Compound Muscle Action Potential (CMAP) amplitude of median and ulnar nerves and Sensory Nerve Action Potential (SNAP) amplitude of median, ulnar and sural nerves. The identification of optimum cut-off point of serum endocan could help in evaluating non-diabetic obese patients with PN in attempt to decrease health hazards related to neuropathy. Conclusion: Obese patients with PN had higher values of circulating endocan than obese patients without PN; the diagnostic power of circulating endocan was highly significant thus it could be used as a diagnostic biomarker of PN.

Serum Endocan Levels Predict Drug-Eluting Stent Restenosis in Patients with Stable Angina Pectoris.

Endothelial cell-specific molecule 1 (ESM-1 or endocan) is an immunoinflammatory marker strongly associated with inflammation, vascular endothelial dysfunction and atherosclerosis. We explored the relationship between serum endocan concentrations and coronary in-stent restenosis (ISR). Fifty consecutive patients with ISR and 50 control subjects were included in this study. Clinical data and angiographic characteristics were collected. Serum endocan concentrations were measured using an enzyme-linked immunosorbent assay. All included patients were divided into four quartiles based on their concentrations of endocan: quartile 1 (0.62-1.31 ng/mL), quartile 2 (1.33-1.74 ng/mL), quartile 3 (1.75-2.77 ng/mL) and quartile 4 (2.78-4.24 ng/mL). The rates of ISR were 16%, 24%, 68%, and 92%, respectively. The patients in quartile 4 had significantly higher rates of ISR than the other groups (p < 0.001). Logistic regression analysis indicated that endocan concentration [odds ratio = 8.65, 95% confidence interval 3.56-20.94; p < 0.001] was an independent predictor of ISR. Receiver operating characteristic curve analysis was used to explore the relationship between endocan and ISR. Using a cutoff value of 1.625 ng/mL, endocan predicted ISR with a sensitivity of 86% and a specificity of 78%. Our findings suggest that plasma endocan levels may be a novel biomarker of endothelial dysfunction in patients with ISR.

Relationship between Serum Endocan Levels and Childhood Community-Acquired Pneumonia.

Community-acquired pneumonia (CAP) is a potentially lethal lower respiratory tract infection for children. For this reason, early recognition and appropriate treatment is essential. In addition, we need to determine which patient will be hospitalized or not hospitalized. Here, we aimed to evaluate the plasma endocan level to determine whether it is effective in making the decision on hospitalization and the assessment of the response to treatment in patients with CAP. This prospective case-control study was conducted between November 2015 and May 2016 at Erciyes University School of Medicine. Fifty-three patients diagnosed as CAP with clinical and radiological findings were enrolled in the study. The patients were divided into various subgroups, such as inpatient, outpatient, complicated, non-complicated, dead patients, etc., and the levels of endocan were compared between the control group and those various groups. A total of 53 children with a diagnosis of CAP and 55 healthy children were enrolled in the study. Patients were divided into two groups: hospitalized patients and outpatients. There was no statistically significant difference between these groups' serum endocan levels on the 1st day and serum endocan levels on the 4th day (p=0.783, p=0.419). Serum endocan level had no significant value in predicting patients' hospitalization. On the other hand, high serum endocrine levels may be important in predicting the severity and prognosis of the disease.

Plasma Endocan Levels in Early and Late-Onset Preeclampsia

Background Preeclampsia (PE) may represent an inflammatory process. Endocan (ESM-1) is a marker of endothelial inflammation. We compared plasma endocan levels between PE and control groups and between early and late-onset PE. Study design: Maternal plasma endocan levels were measured in 41 preeclampsia (PE) pregnancies – 25 early-onset (<34 weeks); 16 late-onset (≥34 weeks), and 37 non-complicated pregnancies (22 matched with early-onset PE, 15 with late onset). Results: There was no significant differences between plasma endocan levels of patients with PE and control group (468.8(IQR: 169.7)ng/L vs 462.4(IQR: 321.1)ng/L, p > 0.05), between early and late-onset PE (458.8(221.8)ng/L vs 469.8(122.6)ng/L, p > 0.05), between early-onset PE and corresponding control group (458.8(221.8)ng/L vs 506.2(1481.9)ng/L, p > 0.05), or late-onset PE and corresponding control group (469.8(122.6)ng/L vs 451.0(85.1)ng/L, p > 0.05). Conclusion: There was no significant difference between endocan levels of early or late-onset PE compared with their corresponding control groups, nor between early and late-onset preeclampsia groups.

Endocan as a marker of microvascular inflammation in kidney transplant recipients

Endocan is a water-soluble proteoglycan exclusively secreted by vascular endothelium. Endocan levels may be elevated in kidney transplant recipients experiencing antibody-mediated rejection (ABMR), which is characterized by vascular inflammation in transplanted kidney. We evaluated the clinical relevance of endocan as markers of microvascular inflammation in patients who underwent kidney transplantation. Plasma and urinary endocan levels were measured in 203 kidney transplant recipients and were compared across different etiologies of allograft dysfunction and various pathologic scores. Both plasma and urinary endocan levels were significantly higher in patients with acute ABMR than those in patients with normal pathology, acute tubular necrosis (ATN), acute pyelonephritis, BK virus associated nephropathy (BKVN), and T-cell mediated rejection (TCMR). Patients with chronic active ABMR also exhibited significantly higher plasma and urinary endocan levels than patients with long-term graft survival. Scores of glomerulitis and peritubular capillaritis, which are typical features of microvascular inflammation, were significantly elevated in patients with higher plasma and/or urinary endocan levels. Furthermore, plasma and urinary endocan levels could effectively discriminate ABMR from ATN, BKVN, and TCMR. Finally, patients exhibiting high urinary and plasma endocan levels in acute ABMR group showed significantly worse renal survival. Altogether, plasma and urinary endocan levels may serve as potential markers of microvascular inflammation in kidney transplant recipients.

Relationship between Plasma Endocan Level and Clinical Outcome of Chinese Peritoneal Dialysis Patients

Background: Endocan is associated with endothelial dysfunction. In peritoneal dialysis (PD) patients, cardiovascular disease is a common cause of mortality. We examined the relationship between serum endocan level and clinical outcome of PD patients. Methods: We recruited 193 new PD patients (118 males, mean age 58.8 ± 11.6 years). Serum endocan levels were determined and stratified into tertile 1 (lowest) to 3 (highest). Nutritional status, arterial pulse wave velocity (PWV) and serum C-reactive protein (CRP) levels were measured. The patients were followed for at least 4 years for clinical outcomes. Results: For the whole cohort, patients with higher serum endocan levels had lower serum albumin and subjective global assessment score, higher carotid-femoral PWV, and higher serum CRP. For patients with suboptimal blood pressure (BP) control, cardiovascular event-free survival was 95.0, 95.5, and 78.5% for tertiles 1, 2, and 3 at 60 months respectively (p = 0.019). Multivariate Cox regression analysis showed that serum endocan level was an independent predictor of cardiovascular event-free survival. No association with cardiovascular event-free survival was found for patients with adequate BP control (95.0, 92.3, and 100% for tertile 1, 2, and 3 at 60 months, respectively, p = 0.6). Conclusions: Higher serum endocan level is associated with unfavourable nutritional, arterial and inflammatory conditions in PD patients. In patients with suboptimal BP control, higher serum endocan is also associated with worse cardiovascular outcome.

Abstract P123: Plasma Endocan Level as a Predictor of Cardiovascular Composite Outcomes in Patients With End-Stage Renal Disease

Background: Endocan, a proteoglycan which is a potential biomarker of endothelial dysfunction, has been shown to be associated with increased cardiovascular risk. We investigated plasma levels of endocan in patients with end-stage renal disease (ESRD) on hemodialysis to predict the risk of cardiovascular diseases. Methods: A total of 400 adult patients with ESRD undergoing hemodialysis were prospectively enrolled in 4 tertiary hospitals of South Korea from June 2016 to May 2018. They were observed for development of the cardiovascular composite outcomes. We compared clinical characteristics and the plasma levels of endocan between 47 patients with cardiovascular composite outcomes and 353 control patients without cardiovascular composite outcomes, and developed the predictive markers of cardiovascular diseases using Cox proportional-hazard analysis. Results: Previous histories of diabetes, acute coronary syndrome, arrhythmia and congestive heart failure were higher in ESRD patients with the cardiovascular composite outcomes than control patients. Patients with cardiovascular composite outcomes showed lower levels of hemoglobin, albumin, and high-density lipoproteins compared with control patients. Higher level of plasma endocan and white blood cells were associated with patients with cardiovascular composite outcomes. Cox proportional-hazard analysis showed that previous histories of diabetes and plasma level endocan were significantly associated with cardiovascular composite outcomes: hazard ratios were 2.1 (95% confidential interval (CI), 1.1 to 4.3) ( p = 0.03) for diabetes and 15.4 (95% CI, 3.2 to 75.2) ( p = 0.001) for endocan (log pg/mL). The patients with level of endocan of 2.96 log pg per mL or more showed significantly higher cumulative incidence of the cardiovascular composite outcomes in Kaplan-Meier curve ( p = 0.03). Conclusions: Plasma Endocan level can a useful biomarker for prediction of cardiovascular diseases in patients with ESRD on hemodialysis.

Is the plasma endocan level a reliable predictor for the severity of erectile dysfunction?

The aim of our study was to assess the correlation between serum endocan level and erectile dysfunction (ED). A total of 92 patients were reviewed in this study after institutional review board approval. The patients' characteristics were recorded, including age, body mass index, blood pressure, smoking history, serum creatinine, glucose, lipid profile, total testosterone, and Beck Depression Inventory scores. ED was evaluated with the Sexual Health Inventory for Men (SHIM) questionnaire and classified as severe, moderate, or mild. Scores of > 18 indicate normal erectile function and were recruited for the control group. Sixty-three patients with a median age of 56years in the ED group and 29 patients with a median age of 55years in the control group were compared. ED was classified as severe in 20, moderate in 25, and mild in 18 patients. A significant difference was determined between the severe ED group and the control group for serum endocan levels (p < 0.001). A significant negative correlation between the SHIM score and endocan levels (rho -0.65; p < 0.01), age and SHIM score (rho -0.32; p = 0.04), BMI and SHIM score (rho -0.25; p = 0.03), and BMI and total testosterone (rho -0.16; p = 0.04) was determined upon Spearman's correlation analysis. A positive correlation was also determined between total testosterone and SHIM score (rho 0.50; p = 0.04). Patients' age (p = 0.037) and serum endocan level (p = 0.029) were determined as significant in the multivariate analysis. This study demonstrated the presence of an association between plasma endocan levels and ED. Endocan may be used as a new diagnostic marker for the severity of ED.

Serum endocan level and its prognostic significance in breast cancer patients

Abstract Background Endocan, known as endothelial cell specific molecule (ESM), is a novel endothelial dysfunction marker. The aim of this study is to examine the plasma endocan level and its prognostic significance in newly diagnosed breast cancer patients. Methods A total of 84 patients were enrolled the study. Plasma endocan level was measured by specific enzyme-linked immunosorbent assay (ELISA) kit. Ethical approval and informed consent were attained. Results At the time of diagnosis, 33 patients had stage 4 disease. The median plasma endocan level was 619.9 (min 259.9–2813.2) ng/L and its level was significantly higher in metastatic breast cancer group compared to non–metastatic breast cancer group. According to molecular sub-type of breast cancer, there is not statistical difference in plasma endocan level, but its level was higher in patients with Her-2 amplified and triple negative breast cancer (TNBC). Median follow-up time is 11 (1-30) months. Event free survival (EFS) was 15 months in patients with plasma endocan level lower than 620, while it was 4 months in patients with serum endocan level greater than 620 (p = 0.016). There was no difference between groups in terms of hypertension, age, Lymphovascular invasion (LVI), extra capsular extension (ECE), body mass index (BMI) and White blood cells (WBC), platelet count and plasma endocan level. Conclusion Plasma endocan levels higher than non metastatic breast cancer. Patients with high plasma endocan levels are short EFS. Further studies would be useful to assess endocan level as a prognostic factor in breast cancer.

Endocan as an early biomarker of severity in patients with acute respiratory distress syndrome

BackgroundPlasma concentrations of endocan, a proteoglycan preferentially expressed in the pulmonary vasculature, may represent a biomarker of lung (dys)function. We sought to determine whether the measurement of plasma endocan levels early in the course of acute respiratory distress syndrome (ARDS) could help predict risk of death or of prolonged ventilation.MethodsAll patients present in the department of intensive care during a 150-day period were screened for ARDS (using the Berlin definition). Endocan concentrations were measured at the moment of ARDS diagnosis (T0) and the following morning (T1). We compared data from survivors and non-survivors and data from survivors with less than 10 days of ventilator support (good evolution) and those who died or needed more than 10 days of mechanical ventilation (poor evolution). Results are presented as numbers (percentages), mean ± standard deviation or medians (percentile 25–75).ResultsNinety-six consecutive patients were included [median APACHE II score of 21 (17–27) and SOFA score of 9 (6–12), PaO2/FiO2 ratio 155 (113–206)]; 64 (67%) had sepsis and 51 (53%) were receiving norepinephrine. Non-survivors were older (66 ± 15 vs. 59 ± 18 years, p = 0.045) and had higher APACHE II scores [27 (22–30) vs. 20 (15–24), p < 0.001] and blood lactate concentrations at study inclusion [2.1 (1.3–4.0) vs. 1.5 (0.9–2.6) mmol/L, p = 0.024] than survivors, but PaO2/FiO2 ratios [150 (116–207) vs. 158 (110–206), p = 0.95] were similar in the two groups. Endocan concentrations on the day after ARDS diagnosis were significantly higher in patients with poor evolution than in those with good evolution [12.0 (6.8–18.6) vs. 7.2 (5.4–12.5), p < 0.01].ConclusionBlood endocan concentrations early in the evolution of ARDS may be a useful marker of disease severity.

Plasma endocan level and prognosis of immunoglobulin A nephropathy

BackgroundEndocan, previously called endothelial cell–specific molecule-1, is a soluble proteoglycan that is secreted from vascular endothelial cells. Elevated plasma endocan levels were shown to be associated with poor cardiovascular outcomes in patients with chronic kidney disease (CKD). We investigated the clinical relevance of plasma and urine endocan levels in patients with immunoglobulin A nephropathy (IgAN). MethodsSixty-four patients with IgAN and 20 healthy controls were enrolled in this study. Plasma and urine endocan levels were measured. Clinical parameters, pathologic grades, and renal outcomes were compared among subgroups with different plasma and urine endocan levels. ResultsBoth plasma and urine endocan levels were significantly higher in patients with IgAN than in controls. Elevated serum phosphorus and C-reactive protein were independent determinants for plasma endocan, and elevated C-reactive protein was also an independent determinant for urine endocan levels in multivariate analysis. Plasma endocan level was not significantly different across CKD stages, but patients with higher plasma endocan levels showed adverse renal outcome. Urine endocan levels were also elevated in patients with poor renal function. Cox proportional hazard models showed that high plasma endocan was an independent risk factor for CKD progression after adjusting for the well-known predictors of outcome in patients with IgAN. ConclusionThis study suggested that plasma endocan might be useful as a prognostic factor in patients with IgAN.

Plasma Endocan Levels in Patients With Isolated Coronary Artery Ectasia.

Endocan is a soluble proteoglycan, secreted by human vascular endothelial cells. Endocan is a marker for vascular pathologies and an important mediator of angiogenesis, strongly associated with inflammation, vascular endothelial dysfunction, and atherosclerosis. The relationship between coronary artery ectasia (CAE) and endocan has not been evaluated. We aimed to investigate this association. Fifty-four patients with isolated CAE without coronary stenosis and 30 controls with normal coronary angiogram were included in this study. Endocan plasma concentrations were measured using an enzyme-linked immunosorbent assay. Patients with isolated CAE had significantly higher levels of endocan compared to the controls (18.9 ± 7.3 vs 15.6 ± 3.6 ng/mL; P = .007). There was a significant correlation between endocan levels and severity of isolated CAE according to the Markis classification ( r = -.593, P < .001). Plasma endocan levels may reflect the presence and severity of isolated CAE, suggesting that endocan may be involved in pathogenesis of isolated CAE.

Tissue and Plasma Endocan and Endoglin Levels in Patients with Bladder Cancer

Objective: In this study, we aimed to compare plasma endoglin and endocan levels between bladder cancer patients and the control group. The secondary aim of the study was to compare plasma and tissue endoglin and endocan levels between high grade and low grade bladder cancers. Methods: A total of 36 patients with bladder cancer and 20 patients as control group were included. Eight milliliters of peripheral venous blood sample was taken from both study and control group to determine plasma Endocan and Endoglin levels. A tissue sample of 0.5 cm3 was obtained by cystoscopy and resection of papillary lesion of bladder to determine tissue Endocan and Endoglin levels. Results were compared between bladder cancer and control group. Result: The mean plasma Endoglin levels were 10.2 (4.5-13.7) ng/mL in low grade bladder cancer, 14.6 (8.4-22.3) ng/mL in high grade bladder cancer and 8.8 (6.3-19.4) ng/mL in the control group. The mean plasma Endocan levels were 520.4 (346.9-647.6) ng/L in low grade bladder tumors; 728.5 (311.4-1518.1) ng/L in high grade bladder tumors and 479.9 (140.6-864.7) ng/L in the control group. Plasma Endoglin level of control group was significantly lower than bladder cancer group (p<0.001). Plasma Endocan level was not different between bladder cancer and control group (p=0.117). Conclusions: Plasma Endoglin level was up-regulated in bladder cancer patients whereas plasma Endocan level did not show any difference.

Endocan: a novel predictor of endothelial dysfunction in obstructive sleep apnea syndrome.

Obstructive sleep apnea syndrome (OSA) is an independent risk factor for endothelial dysfunction and cardiometabolic diseases. Plasma endocan levels are elevated in a large number of diseases, and is a novel surrogate endothelial cell dysfunction marker. We aimed to assess the role of serum endocan level as a potential mechanism of endothelial dysfunction in OSA patients. This was a cohort study in which patients who had undergone a sleep study for diagnosis of OSA were recruited. Included patients were grouped according to apnea-hypopnea index (AHI) as mild, moderate and severe OSA. Patients with AHI < 5 served as control group. Endothelial function was evaluated with flow-mediated dilatation (FMD). Plasma endocan level was measured for all patients. One hundred twenty eight OSA patients included (15 controls, 22 with mild, 22 with moderate and 69 with severe OSA). The mean age was 51.6 ± 11.9 years and 43.8% (56/128) of the study population was female. As expected, the prevalence of hypertension, diabetes and cardiovascular disease increased as the severity of OSA increased. Endocan levels were significantly higher and FMD measurements were lower in patients with OSA compared to healthy controls. There was a positive correlation between AHI and serum endocan levels (rho = 0.826, P < 0.0001) and there was a negative correlation between AHI and FMD (rho = -0.686, P < 0.0001) In addition, we observed a strong negative correlation between serum endocan level and FMD (rho = -0.613, P < 0.0001). In linear regression analysis AHI was independently related both with endocan (P < 0.0001) and FMD (P = 0.011). Serum endocan level is strongly associated with the severity of OSA and endothelial dysfunction. Endocan might be a useful early novel marker for premature vascular endothelial system damage in OSA patients.