Angiopoietin-1 and angiopoietin-2 as clinically informative prognostic biomarkers of morbidity and mortality in severe sepsis*

Ricciuto, Daniel R.; Santos, Claudia C. dos; Hawkes, Michael; Toltl, Lisa J.; Conroy, Andrea L.; Rajwans, Nimerta; Lafferty, Erin I.; Cook, Deborah J.; Fox-Robichaud, Alison; Kahnamoui, Kamyar; Kain, Kevin C.; Liaw, Patricia C.; Liles, W. Conrad

doi:10.1097/ccm.0b013e318206d285

Cited by 187 publications

(172 citation statements)

References 45 publications

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“…Recently, Ricciuto et al (2011) confirmed, in their study with 70 patients, the predictive power of Ang-1 and -2 as prognostic marker in the course of sepsis. Ang-1 plasma levels at admission and during the course of disease, both Ang-1 and -2 highly correlated with 28-day mortality in severe sepsis.…”

Section: Ang-1 and -2mentioning

confidence: 51%

Biomarkers of endothelial dysfunction: can they help us deciphering systemic inflammation and sepsis?

2011

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Section: Ang-1 and -2mentioning

confidence: 51%

Biomarkers of endothelial dysfunction: can they help us deciphering systemic inflammation and sepsis?

2011

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“…Regarding their antagonistic roles, especially the balance between Angiopoietin-1 and -2 (Ang-1 and -2) is of particular importance [118] . In a multicenter cohort study, low plasma levels of Ang-1 at admission as well as serially measured Ang-1 and -2 were associated with higher 28-d mortality in critically ill patients with severe sepsis [119] . Additionally, in patients with suspected infection, elevated Ang-2 plasma levels were detected during the first hour after admission and correlated with the development of severe sepsis and a higher mortality [120] .…”

Section: Angiopoetin-1 Und -2mentioning

confidence: 99%

Are there new approaches for diagnosis, therapy guidance and outcome prediction of sepsis?

Kojic

Siegler

Uhle

et al. 2015

WJEM

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Beside many efforts to improve outcome, sepsis is still one of the most frequent causes of death in critically ill patients. It is the most common condition with high mortality in intensive care units. The complexity of the septic syndrome comprises immunological aspects -i.e. , sepsis induced immunosuppression -but is not restricted to this fact in modern concepts. So far, exact mechanisms and variables determining outcome and mortality stay unclear. Since there is no typical risk profile, early diagnosis and risk stratification remain difficult, which hinders rapid and effective treatment initiation. Due to the heterogeneous nature of sepsis, potential therapy options should be adapted to the individual. Biomarkers like C-reactive protein and procalcitonin are routinely used as complementary tools in clinical decision-making. Beyond the acute phase proteins, a wide bunch of promising substances and non-laboratory tools with potential diagnostic and prognostic value is under intensive investigation. So far, clinical decision just based on biomarker assessment is not yet feasible. However, biomarkers should be considered as a complementary approach. Core tip: Sepsis is a complex continuum of disturbed systems. Despite the presence of clinical consensus criteria, the early diagnosis especially in the perioperative setting is challenging. A magnitude of potential new biomarkers is tested for this purpose, but evidence is mounting that due to the complex nature of the syndrome, biomarkers are rather complementary tools for clinical decision making than "magic bullets". Moreover, biomarkers are also evaluated for therapy guidance, linking diagnostic results to an individual therapeutic regime. This review summarizes the developments in the biomarker field, aiming to provide an overview about current targets and their limitations.

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“…En cuanto a la Ang-2, se almacena en los cuerpos de WeibelPalade, de donde se libera para los procesos de desestabilización del endotelio por disrupción celular, antagonizando los efectos de la Ang-1 e incrementando la inflamación y la activación endotelial, con la consecuente pérdida de plasma y hemorragia (15,28). Se ha observado que las dos son relevantes en los procesos que desembocan en la gravedad de los pacientes en estado crítico, sin que hasta la fecha se hayan dilucidado completamente los mecanismos de dicha actividad (29). En cuanto a los demás reguladores endoteliales, se ha observado que en poblaciones heterogéneas (modelos animales y pacientes con dengue grave), algunos de ellos se han correlacionado con manifestaciones vasculares e inflamatorias, lo cual podría ser un campo de desarrollo de tratamientos farmacológicos (22,28).…”

Section: Discussionunclassified

Reguladores de integridad endotelial como posibles predictores de la gravedad en casos de dengue

2016

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Introducción. El dengue es una de las enfermedades trasmitidas por mosquitos de mayor impacto en el mundo. La evolución clínica de la enfermedad suele ser impredecible, por lo cual su adecuado manejo en las fases tempranas podría incidir en la mejoría del paciente. Objetivo. Evaluar los niveles séricos de algunos reguladores endoteliales (VEGF, sICAM-1, endoglina soluble, Ang-1 y Ang-2) como marcadores de predicción de la gravedad del dengue. Materiales y métodos. Se hizo un estudio de casos y controles anidado en una cohorte. En la fase temprana, los niveles de los reguladores endoteliales se midieron con ELISA. La relación entre las variables clínicas y los reguladores se analizó mediante regresión logística utilizando como variable de salida la gravedad del dengue. Con base en la relación entre las variables de interés y el resultado, se estableció un posible modelo predictor de la gravedad empleando la mejor área bajo la curva (ROC). Resultados. La mediana de la edad fue de 24 años. Los casos graves se asociaron con niveles séricos de Ang-2 a partir de un punto de corte mayor o igual a 1.490 pg/ml, (Odds ratio, OR=3,1 p=0,015). Los niveles séricos de Ang-2, así como un área de 0,73 bajo la curva ROC, contribuyeron al modelo de predicción de la gravedad, conjuntamente con las variables de exantema, trastorno de conciencia y dolor abdominal, con OR de 3,2 (IC95% 1,16-8,9; p=0,024). Conclusión. El regulador endotelial Ang-2 podría ser un predictor de la gravedad en el dengue.

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Angiopoietin-1 and angiopoietin-2 as clinically informative prognostic biomarkers of morbidity and mortality in severe sepsis*

Cited by 187 publications

References 45 publications

Biomarkers of endothelial dysfunction: can they help us deciphering systemic inflammation and sepsis?

Biomarkers of endothelial dysfunction: can they help us deciphering systemic inflammation and sepsis?

Are there new approaches for diagnosis, therapy guidance and outcome prediction of sepsis?

Reguladores de integridad endotelial como posibles predictores de la gravedad en casos de dengue

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