Admission angiopoietin levels in children with septic shock

被引:121
作者
Giuliano, John S., Jr.
Lahni, Patrick M.
Harmon, Kelli
Wong, Hector R.
Doughty, Lesley A.
Carcillo, Joseph A.
Zingarelli, Basilia
Sukhatme, Vikas P.
Parikh, Samir M.
Wheeler, Derek S.
机构
[1] Childrens Hosp, Med Ctr, Childrens Res Fdn, Div Crit Care Med,Kindelt Lab Crit Care Med Res, Cincinnati, OH 45229 USA
[2] Univ Cincinnati, Coll Med, Dept Pediat, Cincinnati, OH 45221 USA
[3] Univ Pittsburgh, Med Ctr, Childrens Hosp Pittsburgh, Dept Crit Care Med, Pittsburgh, PA 15260 USA
[4] Harvard Med Sch, Beth Israel Deaconess Med Ctr, Dept Med, Boston, MA USA
来源
SHOCK | 2007年 / 28卷 / 06期
关键词
angiopoietin-1; angiopoietin-2; septic shock; children; Tie-2; angiogenesis; capillary leak; endothelial injury;
D O I
10.1097/shk.0b013e318123867b
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Angiopoietin (angpt) 1 and angpt-2 are circulating proteins first ascribed opposing roles in embryonic angiogenesis. Both bind the tyrosine kinase with immunoglobulin-like loop and epidermal growth factor homology domains (Tie) 2 receptor on endothelial cells, but angpt-1 is a Tie-2 agonist, whereas angpt-2 antagonizes Tie-2 signaling. In the developed vasculature, angpt-1 protects against vascular leak, whereas angpt-2 promotes increased vascular permeability. Because alterations in vascular permeability are common in septic shock, we obtained plasma from critically ill children within 24 h of diagnosis of the systemic inflammatory response syndrome (SIRS, n = 20), sepsis (n = 20), or septic shock (n = 61), as well as 15 healthy controls. Plasma levels of angpt-1 and angpt-2 were measured via a commercially available enzyme-linked immunosorbent assay. Plasma angpt-2 levels were significantly elevated in children with septic shock when compared with healthy children, as well as critically ill children with either SIRS or sepsis, and circulating angpt-2 levels seemed to correlate with disease severity and outcome. In addition, plasma angpt-1 levels were significantly decreased in critically ill children with septic shock compared with critically ill children with either SIRS or sepsis. Given the contrasting effects of angpt-2 and angpt-1 on the vascular endothelium, these two factors may play an important role in the pathophysiology of septic shock in children, and further studies are warranted.
引用
收藏
页码:650 / 654
页数:5
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