Endothelin in septic patients: Effects on cardiovascular and renal function and its relationship to proinflammatory cytokines

Tschaikowsky, K.; Sägner, S; Lehnert, Nancy M.; Kaul, Martin; Ritter, Joseph K.

doi:10.1097/00003246-200006000-00028

Cited by 66 publications

(48 citation statements)

References 35 publications

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“…It is synthesized as a much longer polypeptide preproendothelin, being 203 amino acid residues long. Preproendothelin is cleaved by a signal peptidase to pro-ET-1, which in turn is cleaved by ET-converting enzyme (ECE) to the 21 amino acid long ET-1 (Brauner et al 2000;Hemsen et al 1996;Kido et al 1998;Schuetz et al 2011;Schweizer et al 1997;Tschaikowsky et al 2000). Using a sandwich immunoassay, Schuetz and colleagues evaluated proET-1 levels in patients with community-acquired pneumonia (CAP) and found that proET-1 levels at admission were independent predictors of short-term mortality and the need for ICU admission.…”

Section: Et-1 and Its Precursor Peptide Proet-1mentioning

confidence: 99%

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

2011

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Section: Et-1 and Its Precursor Peptide Proet-1mentioning

confidence: 99%

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

2011

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“…Circulating levels of endothelium-derived peptides such as adrenomedullin and endothelin are increased in response to infection and sepsis (12,31). These peptides are important mediators of vascular tone regulation: endothelin is a powerful vasoconstrictor, whereas adrenomedullin induces extreme vasodilatation and hypotension (11).…”

Section: Discussionmentioning

confidence: 99%

“…The existence of a direct association between infections and BNP is supported by evidence from preclinical studies, since LPS and pro-inflammatory cytokines have a direct effect on BNP transcription and translation in cardiomyocytes in vitro (15,30). Infection and sepsis also modulate circulating levels of other vasoactive peptides originating from the cardiovascular system, such as endothelium-derived endothelin-1 (ET-1) and adrenomedullin (12,31), as well as their corresponding prohormone fragments C-terminal pro-endothelin-1 (CT-proET-1) and midregional pro-adrenomedullin (MRproADM) (25,28).…”

mentioning

confidence: 99%

Plasma NT-proBNP increases in response to LPS administration in healthy men

Vila

Resl²,

Stelzeneder³

et al. 2008

Journal of Applied Physiology

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(NT-proBNP) increase in response to volume overload and help in the differential diagnosis of acute heart failure. Elevated plasma BNP levels are observed also in sepsis and do not always correspond to left ventricular dysfunction. Here, we investigated plasma NT-proBNP fluctuations in response to human bacterial endotoxinemia, an experimental model of systemic infection and inflammation. Escherichia coli endotoxin (LPS) (2 ng/kg) was administered to 10 healthy volunteers in a randomized, placebo-controlled, cross-over design. Plasma NTproBNP, C-reactive protein (CRP), COOH terminal pro-endothelin-1 (CT-proET-1), and midregional-pro-adrenomedullin (MR-proADM) were measured at hourly intervals for 6 h. LPS administration induced a continuous increase in plasma NT-proBNP that reached peak values after 6 h (40.7 Ϯ 7.9 vs. 16.1 Ϯ 3.2 pg/ml in placebo days, mean Ϯ SE; P ϭ 0.023). The profile of changes in NT-proBNP correlated to changes in body temperature (P Ͻ 0.001), heart rate (P ϭ 0.005), CRP (P Ͻ 0.001), and CT-proET-1 (P ϭ 0.008), but not to blood pressure values. Our results demonstrate that plasma NT-proBNP increases in a model of systemic infection/inflammation in healthy men with normal heart function. This finding emphasizes the necessity to consider concomitant infections when interpreting elevated circulating NT-proBNP concentrations.B-type natriuretic peptide; C-reactive protein; bacterial endotoxin; infection; inflammation; human B-TYPE NATRIURETIC PEPTIDE (BNP) is secreted from atria and ventricles in response to volume load and myocardial wall stress (6, 24). It promotes vasodilatation, natriuresis, and diuresis (6). In the circulation, the prohormone is cleaved into two peptides: the physiologically active BNP and the inactive NH 2 -terminal-proBNP (NT-proBNP) (1). NT-proBNP has higher plasma levels and a longer half-life and therefore slower fluctuations (6). BNP and NT-proBNP are both helpful in the diagnosis of cardiac dysfunction and heart failure (16, 29) and equivalent in the prognosis of ischemic heart disease (21). Even modest elevations of the peptides are associated with increased risk of cardiovascular events, heart failure, stroke, and all-cause mortality (2, 34).BNP and NT-proBNP plasma levels depend on age and gender, are altered in the presence of renal disease and obesity (6), and are elevated in sepsis (3, 4). NT-proBNP correlates to the Acute Physiology and Chronic Health Evaluation scores and is found to be a prognostic marker in sepsis and septic shock (3, 4). Elevated BNP levels in sepsis might be attributed to the underlying myocardial dysfunction (32). Nevertheless, BNP is elevated also in septic patients with neither clinical nor echocardiographic evidence of left ventricular systolic dysfunction (26). Moreover, increased plasma BNP is found also in patients with infections in the absence of severe sepsis or septic shock (18). The existence of a direct association between infections and BNP is supported by evidence from preclinical studies, since LPS and pro-inflammatory c...

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“…Endotoksemilerde ön-cül proteini olan prepro-ET-1, özellikle kalp ve akciğerlerden salınmaktadır ve mortalite hızlarıyla bağıntılı olarak artış göstermektedir (55,56). Yinelenen pro-ET-1 ölçümlerinin, özellikle toplum kökenli infeksiyonlarda CRP düzeyi ve löko-sit sayısına göre daha yüksek negatif prediktif değeri olduğu gösterilmiştir (57,58).…”

Section: Endotelin-1unclassified

Biomarkers in Bacterial Infections and Sepsis

Sönmezer¹,

Tülek²

2015

Klimik Dergisi

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Sepsis is a life threatening clinical condition which occurs as a result of systemic response to serious bacterial infection. Increase of antibiotic use and supportive therapy has not led to a decrease in the prevalence of sepsis in the world. Because early clinical signs of sepsis are not specific, researchers are looking for new ways to diagnose sepsis earlier using biomarkers. Potential biomarkers for diagnosis of sepsis caused by bacterial infections are reviewed. Klimik Dergisi 2015; 28(3): 96-102.

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Endothelin in septic patients: Effects on cardiovascular and renal function and its relationship to proinflammatory cytokines

Abstract: In patients with severe sepsis, big-ET plasma levels are markedly increased, even above those of multiple trauma patients, in close relationship to IL-6 and IL-8, and with significant correlation to renal function and pulmonary vascular tone.

Cited by 66 publications

References 35 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?

Plasma NT-proBNP increases in response to LPS administration in healthy men

Biomarkers in Bacterial Infections and Sepsis

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