Endocan - a potential diagnostic marker for early onset sepsis in neonates

Abstract

Introduction: Neonatal early onset sepsis assessment is based on the history of pregnancy and delivery and nonspecific clinical signs. None of the biomarkers currently in use for clinical practice has adequate prognostic value, so it is not possible to clearly distinguish neonates with culture-proven sepsis from those with only risk factors or clinical suspicion. Endocan is an endothelial mediator involved in the inflammatory response that is present in low concentrations in the serum of healthy subjects, and in much higher concentrations in patients with SIRS and septic shock. The purpose of this study is to evaluate the utility of serum endocan serum levels as a biomarker for the diagnosis of neonatal early onset sepsis (EOS).
 Methodology: Serum endocan concentration was measured in newborns with clinical suspicion of EOS admitted to the Neonatal Intensive Care Unit on day 1, 3 and 7.
 Results: Serum endocan levels were significantly increased in septic compared to non-septic neonates in the early stages of sepsis (2.43 ± 0.95 vs. 1.77 ± 0.57, p = 0.004), continued to rise up to 72 hours from onset and then decreased by the seventh day under treatment.
 Conclusions: These results suggest a potential role for endocan as an early marker for diagnosis and follow-up in neonatal EOS. Studies on a larger number of cases are needed in order to establish the practical utility of this molecule as a diagnostic tool for clinical practice.

Relevance of Biomarkers Currently in Use or Research for Practical Diagnosis Approach of Neonatal Early-Onset Sepsis

“…For EOS at a cut-off value of 1.62 ng/mL, the reported sensitivity of serum endocan was 88% and the specificity was 50%. At a higher threshold value of >2.15 ng/mL, specificity improved to 81%, but the sensitivity decreased to 52% [106]. This suggests that currently the clinical utility of endocan as a single marker for the diagnosis of neonatal EOS is limited.…”

“…Normally, endocan is localized mainly within the vascular endothelium, the distal tubules of the kidneys and in the lungs, at the level of small veins, arterioles, alveolar capillaries, bronchial epithelial cells and submucosal glands [101]. In healthy subjects, the serum concentration of endocan is low, but the levels are significantly increased in patients with sepsis and are correlated with disease severity [98,[102][103][104][105][106]. Moreover, in newborns without infection, during the first 72 h of life, endocan serum level does not appear to be significantly influenced by sex, delivery method, the presence of meconium in the amniotic fluid, fetal bradycardia/tachycardia or presence of minor birth trauma (ecchymosis, cephalohematoma, clavicle fracture), which have been associated with elevation of CRP and PCT [107].…”

Acute Clinical Syndromes and Suspicion of SARS-CoV-2 Infection: The Experience of a Single Romanian Center in the Early Pandemic Period

“…This situation can be explained by all patients having acute clinical syndromes, giving rise to different changes in laboratory measures. Some patients had chronic coronary syndromes and acute coronary syndromes (in which LDH, CKMB, troponin, and CRP levels increased), chronic heart failure and acute heart failure (with an increase in cardiac enzymes as a result of myocardial injury [23]), VTE (with an increase in D-dimer levels as well as cardiac enzymes [24]), acute inflammatory conditions such as exacerbations of COPD or septic conditions (with an increase in CRP, as well as D-dimer or ferritin [25][26][27][28]), and chronic liver disease (in which LDH, ferritin [29], and D-dimer levels can increase [30]).…”

Serum biomarkers of endothelial glycocalyx injury in canine parvoviral infection

“…Our results showed a significant decrease of ESM-1 levels in the blood samples taken at the time of discharge compared to the levels at the time of admission. In human neonatal septicemia, Zonda et al (2019) found the level of endocan at the time of admission was significantly higher in septic neonates than in non-septic ones and remained high until the 3 rd day from admission, before returning to their normal values on day 7 (Lassalle et al 1996, Bechard et al 2000, Zonda et al 2019. The findings of the present study suggest that dogs with PVE had high levels of ESM-1 at the time of admission and after the treatment and the resolution of the inflammatory state, while the levels of ESM-1 in the recovered dogs tended to decrease and were comparable with the healthy group.…”