TY - JOUR
T1 - Endothelial damage in septic shock patients as evidenced by circulating syndecan-1, sphingosine-1-phosphate and soluble VE-cadherin
T2 - a substudy of ALBIOS
AU - the ALBIOS Investigators
AU - Piotti, Arianna
AU - Novelli, Deborah
AU - Meessen, Jennifer Marie Theresia Anna
AU - Ferlicca, Daniela
AU - Coppolecchia, Sara
AU - Marino, Antonella
AU - Salati, Giovanni
AU - Savioli, Monica
AU - Grasselli, Giacomo
AU - Bellani, Giacomo
AU - Pesenti, Antonio
AU - Masson, Serge
AU - Caironi, Pietro
AU - Gattinoni, Luciano
AU - Gobbi, Marco
AU - Fracasso, Claudia
AU - Latini, Roberto
AU - Bruzzone, Paola
AU - Pagan, Francesca
AU - Russo, Riccarda
AU - Confalonieri, Andrea
AU - Abbruzzese, Chiara
AU - Vergnano, Beatrice
AU - Faenza, Stefano
AU - Siniscalchi, Antonio
AU - Pierucci, Elisabetta
AU - Noto, Andrea
AU - Pezzi, Angelo
AU - Spanu, Paolo
AU - Parrini, Vieri
AU - Oggioni, Roberto
AU - Pasetti, Giovanni Stefano
AU - Casadio, Maria Cinzia
AU - Buontempo, Rosa
AU - Carrer, Sara
AU - Piccoli, Francesca
AU - Rizzi, Tatiana
AU - Caricato, Anselmo
AU - La Sala, Monica
AU - Antonaci, Alessandra
AU - Fassini, Paola
AU - Paganini, Silvia
AU - Porta, Virginia
AU - Moise, Gabriella
AU - Urbano, Maria Cristina
AU - Ballotta, Andrea
AU - Colombo, Roberto
AU - Maggio, Giuseppe
AU - Rossi, Nicola
AU - Bona, Francesco
N1 - Funding Information:
The Albumin Italian Outcome Sepsis trial was funded by grants from the Italian Medicines Agency (AIFA, grant FARM6JS3R5, 2006), from the Italian Ministry of Health (Ricerca Finalizzata, grant number RF-2011-02348358), and from Grifols (ALBUS Grifols Award, 2015).
Publisher Copyright:
© 2021, The Author(s).
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/12
Y1 - 2021/12
N2 - Background: Septic shock is characterized by breakdown of the endothelial glycocalyx and endothelial damage, contributing to fluid extravasation, organ failure and death. Albumin has shown benefit in septic shock patients. Our aims were: (1) to identify the relations between circulating levels of syndecan-1 (SYN-1), sphingosine-1-phosphate (S1P) (endothelial glycocalyx), and VE-cadherin (endothelial cell junctions), severity of the disease, and survival; (2) to evaluate the effects of albumin supplementation on endothelial dysfunction in patients with septic shock. Methods: This was a retrospective analysis of a multicenter randomized clinical trial on albumin replacement in severe sepsis or septic shock (the Albumin Italian Outcome Sepsis Trial, ALBIOS). Concentrations of SYN-1, S1P, soluble VE-cadherin and other biomarkers were measured on days 1, 2 and 7 in 375 patients with septic shock surviving up to 7 days after randomization. Results: Plasma concentrations of SYN-1 and VE-cadherin rose significantly over 7 days. SYN-1 and VE-cadherin were elevated in patients with organ failure, and S1P levels were lower. SYN-1 and VE-cadherin were independently associated with renal replacement therapy requirement during ICU stay, but only SYN-1 predicted its new occurrence. Both SYN-1 and S1P, but not VE-cadherin, predicted incident coagulation failure. Only SYN-1 independently predicted 90-day mortality. Albumin significantly reduced VE-cadherin, by 9.5% (p = 0.003) at all three time points. Conclusion: Circulating components of the endothelial glycocalyx and of the endothelial cell junctions provide insights into severity and progression of septic shock, with special focus on incident coagulation and renal failure. Albumin supplementation lowered circulating VE-cadherin consistently over time. Clinical Trial Registration: ALBIOS ClinicalTrials.gov number NCT00707122.
AB - Background: Septic shock is characterized by breakdown of the endothelial glycocalyx and endothelial damage, contributing to fluid extravasation, organ failure and death. Albumin has shown benefit in septic shock patients. Our aims were: (1) to identify the relations between circulating levels of syndecan-1 (SYN-1), sphingosine-1-phosphate (S1P) (endothelial glycocalyx), and VE-cadherin (endothelial cell junctions), severity of the disease, and survival; (2) to evaluate the effects of albumin supplementation on endothelial dysfunction in patients with septic shock. Methods: This was a retrospective analysis of a multicenter randomized clinical trial on albumin replacement in severe sepsis or septic shock (the Albumin Italian Outcome Sepsis Trial, ALBIOS). Concentrations of SYN-1, S1P, soluble VE-cadherin and other biomarkers were measured on days 1, 2 and 7 in 375 patients with septic shock surviving up to 7 days after randomization. Results: Plasma concentrations of SYN-1 and VE-cadherin rose significantly over 7 days. SYN-1 and VE-cadherin were elevated in patients with organ failure, and S1P levels were lower. SYN-1 and VE-cadherin were independently associated with renal replacement therapy requirement during ICU stay, but only SYN-1 predicted its new occurrence. Both SYN-1 and S1P, but not VE-cadherin, predicted incident coagulation failure. Only SYN-1 independently predicted 90-day mortality. Albumin significantly reduced VE-cadherin, by 9.5% (p = 0.003) at all three time points. Conclusion: Circulating components of the endothelial glycocalyx and of the endothelial cell junctions provide insights into severity and progression of septic shock, with special focus on incident coagulation and renal failure. Albumin supplementation lowered circulating VE-cadherin consistently over time. Clinical Trial Registration: ALBIOS ClinicalTrials.gov number NCT00707122.
KW - Biomarker
KW - Glycocalyx
KW - Septic shock
KW - Sphingosine-1-phosphate
KW - Syndecan-1
KW - VE-cadherin
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UR - http://www.scopus.com/inward/citedby.url?scp=85103000558&partnerID=8YFLogxK
U2 - 10.1186/s13054-021-03545-1
DO - 10.1186/s13054-021-03545-1
M3 - Article
C2 - 33741039
AN - SCOPUS:85103000558
VL - 25
JO - Critical Care
JF - Critical Care
SN - 1466-609X
IS - 1
M1 - 113
ER -