Endocan levels in peripheral blood predict outcomes of acute respiratory distress syndrome

Ling Tang, Ying Zhao, Daoxin Wang, Wang Deng, Changyi Li, Qi Li, Shicong Huang, Chang Shu, Ling Tang, Ying Zhao, Daoxin Wang, Wang Deng, Changyi Li, Qi Li, Shicong Huang, Chang Shu

Abstract

Purpose: To investigate the prognostic significance of endocan, compared with procalcitonin (PCT), C-reactive protein (CRP),white blood cells (WBC), neutrophils (N), and clinical severity scores in patients with ARDS.

Methods: A total of 42 patients with ARDS were initially enrolled, and there were 20 nonsurvivors and 22 survivors based on hospital mortality. Plasma levels of biomarkers were measured and the acute physiology and chronic health evaluation II (APACHE II) was calculated on day 1 after the patient met the defining criteria of ARDS.

Results: Endocan levels significantly correlated with the APACHE II score in the ARDS group (r = 0.676, P = 0.000, n = 42). Of 42 individuals with ARDS, 20 were dead, and endocan was significantly higher in nonsurvivors than in survivors (median (IQR) 5.01 (2.98-8.44) versus 3.01 (2.36-4.36) ng/mL, P = 0.017). According to the results of the ROC-curve analysis and COX proportional hazards models, endocan can predict mortality of ARDS independently with a hazard ratio of 1.374 (95% CI, 1.150-1.641) and an area of receiver operator characteristic curve (AUROC) of 0.715 (P = 0.017). Moreover, endocan can predict the multiple-organ dysfunction of ARDS.

Conclusion: Endocan is a promising biomarker to predict the disease severity and mortality in patients with ARDS.

Figures

Figure 1
Figure 1
Correlations of plasma endocan with procalcitonin (PCT), C-reactive protein (CRP), white blood cells (WBC), and APACHE II in 42 patients with acute respiratory distress syndrome (Spearman rank analysis). r represents Spearman's correlation coefficients, and P value less than 0.05 was considered statistically significant.
Figure 2
Figure 2
Motality prediction by plasma levels of endocan, PCT, CRP, WBC and Neutrophil counts and APACHE II scores in patients with acute respiratory distress syndrome using the receiver operating characteristic (ROC) curves.The optimal cutoff points for each plasma biomarker level and severity score were listed in the attached table, P value less than 0.05 was considered statistically significant.

References

    1. Phua J, Badia JR, Adhikari NKJ, et al. Has mortality from acute respiratory distress syndrome decreased over time? American Journal of Respiratory and Critical Care Medicine. 2009;179(3):220–227.
    1. Rubenfeld GD, Herridge MS. Epidemiology and outcomes of acute lung injury. Chest. 2007;131(2):554–562.
    1. Herridge MS, Tansey CM, Matté A, et al. Functional disability 5 years after acute respiratory distress syndrome. The New England Journal of Medicine. 2011;364(14):1293–1304.
    1. Stüber F, Wrigge H, Schroeder S, et al. Kinetic and reversibility of mechanical ventilation-associated pulmonary and systemic inflammatory response in patients with acute lung injury. Intensive Care Medicine. 2002;28(7):834–841.
    1. Ware LB, Koyama T, Billheimer DD, et al. Prognostic and pathogenetic value of combining clinical and biochemical indices in patients with acute lung injury. Chest. 2010;137(2):288–296.
    1. Prabhakaran P, Ware LB, White KE, Cross MT, Matthay MA, Olman MA. Elevated levels of plasminogen activator inhibitor-1 in pulmonary edema fluid are associated with mortality in acute lung injury. The American Journal of Physiology—Lung Cellular and Molecular Physiology. 2003;285(1):L20–L28.
    1. Ware LB, Fang X, Matthay MA. Protein C and thrombomodulin in human acute lung injury. The American Journal of Physiology—Lung Cellular and Molecular Physiology. 2003;285(3):L514–L521.
    1. Sato H, Callister MEJ, Mumby S, et al. KL-6 levels are elevated in plasma from patients with acute respiratory distress syndrome. European Respiratory Journal. 2004;23(1):142–145.
    1. Determann RM, Royakkers AANM, Haitsma JJ, et al. Plasma levels of surfactant protein D and KL-6 for evaluation of lung injury in critically ill mechanically ventilated patients. BMC Pulmonary Medicine. 2010;10, article 6
    1. Nakamura T, Sato E, Fujiwara N, Kawagoe Y, Maeda S, Yamagishi S. Increased levels of soluble receptor for advanced glycation end products (sRAGE) and high mobility group box 1 (HMGB1) are associated with death in patients with acute respiratory distress syndrome. Clinical Biochemistry. 2011;44(8-9):601–604.
    1. Agrawal A, Matthay MA, Kangelaris KN, et al. Plasma angiopoietin-2 predicts the onset of acute lung injury in critically ill patients. American Journal of Respiratory and Critical Care Medicine. 2013;187(7):736–742.
    1. Uchida T, Shirasawa M, Ware LB, et al. Receptor for advanced glycation end-products is a marker of type I cell injury in acute lung injury. The American Journal of Respiratory and Critical Care Medicine. 2006;173(9):1008–1015.
    1. Calfee CS, Eisner MD, Parsons PE, et al. Soluble intercellular adhesion molecule-1 and clinical outcomes in patients with acute lung injury. Intensive Care Medicine. 2009;35(2):248–257.
    1. Lassalle P, Molet S, Janin A, et al. ESM-1 is a novel human endothelial cell-specific molecule expressed in lung and regulated by cytokines. Journal of Biological Chemistry. 1996;271(34):20458–20464.
    1. Bechard D, Meignin V, Scherpereel A, et al. Characterization of the secreted form of endothelial-cell-specific molecule 1 by specific monoclonal antibodies. Journal of Vascular Research. 2000;37(5):417–425.
    1. Béchard D, Scherpereel A, Hammad H, et al. Human endothelial-cell specific molecule-1 binds directly to the integrin CD11a/CD18 (LFA-1) and blocks binding to intercellular adhesion molecule-1. Journal of Immunology. 2001;167(6):3099–3106.
    1. Scherpereel A, Depontieu F, Grigoriu B, et al. Endocan, a new endothelial marker in human sepsis. Critical Care Medicine. 2006;34(2):532–537.
    1. Mihajlovic DM, Lendak DF, Brkic SV, et al. Endocan is useful biomarker of survival and severity in sepsis. Microvascular Research. 2014;93:92–97.
    1. Ranieri VM, Rubenfeld GD, Thompson BT, et al. Acute respiratory distress syndrome: the Berlin definition. The Journal of the American Medical Association. 2012;307(23):2526–2533.
    1. Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II: a severity of disease classification system. Critical Care Medicine. 1985;13(10):818–829.
    1. Terpstra ML, Aman J, van Nieuw Amerongen GP, Groeneveld AB. Plasma biomarkers for acute respiratory distress syndrome: a systematic review and meta-analysis. Critical Care Medicine. 2014;42(3):691–700.
    1. Lee H. Procalcitonin as a biomarker of infectious diseases. Korean Journal of Internal Medicine. 2013;28(3):285–291.
    1. Mikkelsen ME, Shah CV, Scherpereel A, et al. Lower serum endocan levels are associated with the development of acute lung injury after major trauma. Journal of Critical Care. 2012;27(5):522.e11–522.e17.
    1. Calfee CS, Eisner MD, Ware LB, et al. Trauma-associated lung injury differs clinically and biologically from acute lung injury due to other clinical disorders. Critical Care Medicine. 2007;35(10):2243–2250.

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