BACKGROUND:Angiopoietin-2 and vascular endothelial growth factor (VEGF) may impair vascular barrier function while angiopoietin-1 may protect it. It was hypothesised that circulating angiopoietin-2 is associated with pulmonary permeability oedema and severity of acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) during septic or non-septic critical illness. METHODS:Plasma levels of angiopoietin-1 and angiopoietin-2 were measured in mechanically ventilated patients (24 with sepsis, 88 without sepsis), together with the pulmonary leak index (PLI) for 67-gallium-labelled transferrin and extravascular lung water (EVLW) by transpulmonary thermal-dye dilution as measures of pulmonary permeability and oedema, respectively. ALI/ARDS was characterised by consensus criteria and the lung injury score (LIS). Plasma VEGF and von Willebrand factor (VWF) levels were assayed. RESULTS:Angiopoietin-2, VWF, PLI, EVLW and LIS were higher in patients with sepsis than in those without sepsis and higher in patients with ALI/ARDS (n = 10/12 in sepsis, n = 19/8 in non-sepsis) than in those without. VEGF was also higher in patients with sepsis than in those without. Patients with high PLI, regardless of EVLW, had higher angiopoietin-2 levels than patients with normal PLI and EVLW. Angiopoietin-2 correlated with the PLI, LIS and VWF levels (minimum r = 0.34, p<0.001) but not with EVLW. Angiopoietin-2 and VWF were predictive for ARDS in receiver operating characteristic curves (minimum area under the curve = 0.69, p = 0.006). Angiopoietin-1 and VEGF did not relate to the permeability oedema of ALI/ARDS. CONCLUSION: Circulating angiopoietin-2 is associated with pulmonary permeability oedema, occurrence and severity of ALI/ARDS in patients with and without sepsis. The correlation of angiopoietin-2 with VWF suggests activated endothelium as a common source.
RCT Entities:
BACKGROUND:Angiopoietin-2 and vascular endothelial growth factor (VEGF) may impair vascular barrier function while angiopoietin-1 may protect it. It was hypothesised that circulating angiopoietin-2 is associated with pulmonary permeability oedema and severity of acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) during septic or non-septic critical illness. METHODS: Plasma levels of angiopoietin-1 and angiopoietin-2 were measured in mechanically ventilated patients (24 with sepsis, 88 without sepsis), together with the pulmonary leak index (PLI) for 67-gallium-labelled transferrin and extravascular lung water (EVLW) by transpulmonary thermal-dye dilution as measures of pulmonary permeability and oedema, respectively. ALI/ARDS was characterised by consensus criteria and the lung injury score (LIS). Plasma VEGF and von Willebrand factor (VWF) levels were assayed. RESULTS:Angiopoietin-2, VWF, PLI, EVLW and LIS were higher in patients with sepsis than in those without sepsis and higher in patients with ALI/ARDS (n = 10/12 in sepsis, n = 19/8 in non-sepsis) than in those without. VEGF was also higher in patients with sepsis than in those without. Patients with high PLI, regardless of EVLW, had higher angiopoietin-2 levels than patients with normal PLI and EVLW. Angiopoietin-2 correlated with the PLI, LIS and VWF levels (minimum r = 0.34, p<0.001) but not with EVLW. Angiopoietin-2 and VWF were predictive for ARDS in receiver operating characteristic curves (minimum area under the curve = 0.69, p = 0.006). Angiopoietin-1 and VEGF did not relate to the permeability oedema of ALI/ARDS. CONCLUSION: Circulating angiopoietin-2 is associated with pulmonary permeability oedema, occurrence and severity of ALI/ARDS in patients with and without sepsis. The correlation of angiopoietin-2 with VWF suggests activated endothelium as a common source.
Authors: Christian Clajus; Alexander Lukasz; Sascha David; Barbara Hertel; Ralf Lichtinghagen; Samir M Parikh; André Simon; Issam Ismail; Hermann Haller; Philipp Kümpers Journal: Cytokine Date: 2012-07-06 Impact factor: 3.861
Authors: Xiaoguang Sun; Patrick A Singleton; Eleftheria Letsiou; Jing Zhao; Patrick Belvitch; Saad Sammani; Eddie T Chiang; Liliana Moreno-Vinasco; Michael S Wade; Tong Zhou; Bin Liu; Ioannis Parastatidis; Leonor Thomson; Harry Ischiropoulos; Viswanathan Natarajan; Jeffrey R Jacobson; Roberto F Machado; Steven M Dudek; Joe G N Garcia Journal: Am J Respir Cell Mol Biol Date: 2012-07-05 Impact factor: 6.914
Authors: Nadir Yehya; Neal J Thomas; Nuala J Meyer; Jason D Christie; Robert A Berg; Susan S Margulies Journal: Intensive Care Med Date: 2016-04-21 Impact factor: 17.440
Authors: Eleanor A Fallon; Bethany M Biron-Girard; Chun-Shiang Chung; Joanne Lomas-Neira; Daithi S Heffernan; Sean F Monaghan; Alfred Ayala Journal: J Leukoc Biol Date: 2018-02-02 Impact factor: 4.962
Authors: Ashish Agrawal; Michael A Matthay; Kirsten N Kangelaris; John Stein; Jeffrey C Chu; Brandon M Imp; Alfredo Cortez; Jason Abbott; Kathleen D Liu; Carolyn S Calfee Journal: Am J Respir Crit Care Med Date: 2013-04-01 Impact factor: 21.405
Authors: Richard W Pierce; Veronika Shabanova; Michael Canarie; Mathew Pinto; Yong Sing da Silva; Vineet Bhandari; John S Giuliano Journal: Shock Date: 2019-03 Impact factor: 3.454
Authors: Melanie van der Heijden; Peter Pickkers; Geerten P van Nieuw Amerongen; Victor W M van Hinsbergh; Martijn P W J M Bouw; Johannes G van der Hoeven; A B Johan Groeneveld Journal: Intensive Care Med Date: 2009-06-24 Impact factor: 17.440
Authors: Fiona E Lovegrove; Noppadon Tangpukdee; Robert O Opoka; Erin I Lafferty; Nimerta Rajwans; Michael Hawkes; Srivicha Krudsood; Sornchai Looareesuwan; Chandy C John; W Conrad Liles; Kevin C Kain Journal: PLoS One Date: 2009-03-20 Impact factor: 3.240
Authors: Philipp Kümpers; Matijs van Meurs; Sascha David; Grietje Molema; Johan Bijzet; Alexander Lukasz; Frank Biertz; Hermann Haller; Jan G Zijlstra Journal: Crit Care Date: 2009-05-05 Impact factor: 9.097