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Evaluation of endothelial damage in sepsis-related ARDS using circulating endothelial cells

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Abstract

Purpose

Endothelial cell activation and dysfunction are involved in the pathophysiology of ARDS. Circulating endothelial cells (CECs) may be a useful marker of endothelial dysfunction and damage but have been poorly studied in ARDS. We hypothesized that the CEC count may be elevated in patients with sepsis-related ARDS compared to those with sepsis without ARDS.

Methods

ARDS was defined according to the Berlin consensus definition. The study population included 17 patients with moderate or severe ARDS, 9 with mild ARDS, 13 with sepsis and no ARDS, 13 non-septic patients, and 12 healthy volunteers. Demographic, hemodynamic, and prognostic variables, including PaO2/FiO2 ratio, 28-day survival, blood lactate, APACHE II, and SOFA score, were recorded. CECs were counted in arterial blood samples using the reference CD146 antibody-based immunomagnetic isolation and UEA1-FITC staining method. Measurements were performed 12–24 h after diagnosis of ARDS and repeated daily for 3 days.

Results

The median day-1 CEC count was significantly higher in patients with moderate or severe ARDS than in mild ARDS or septic-control patients [27.2 (18.3–49.4) vs. 17.4 (11–24.5) cells/ml (p < 0.034), and 18.4 (9.1–31) cells/ml (p < 0.035), respectively]. All septic patients (with or without ARDS) had higher day-1 CEC counts than the non-septic patients [19.6 (14.2–30.6) vs. 10.8 (5.7–13.2) cells/ml, p = 0.002].

Conclusion

The day-1 CEC count was significantly higher in ARDS patients than in other critically ill patients, and in moderate or severe ARDS patients compared to those with milder disease, making it a potentially useful marker of ARDS severity.

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Acknowledgments

The authors thank Dr. Hassane Njimi for his help with the statistical analysis. We are also grateful to Sébastien Bertil and Florence Desvard for their technical assistance in CEC isolation.

Conflicts of interest

The authors have no conflicts of interest related to this article.

Author information

Authors and Affiliations

  1. Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles (ULB), 808 Route de Lennik, 1070, Brussels, Belgium

    Mouhamed Djahoum Moussa, Cristina Santonocito, David Fagnoul, Katia Donadello, Daniel De Backer & Jean-Louis Vincent

  2. Laboratory of Hematology, Erasme University Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium

    Olivier Pradier

  3. Department of Haematology, AP-HP, Hôpital Européen Georges Pompidou, Paris, France

    Pascale Gaussem

  4. Sorbonne Paris Cité, Université Paris Descartes, Paris, France

    Pascale Gaussem

  5. Faculté de Pharmacie, Inserm UMR-S1140, Paris, France

    Pascale Gaussem

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  1. Mouhamed Djahoum Moussa
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  2. Cristina Santonocito
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Correspondence to Jean-Louis Vincent.

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Moussa, M.D., Santonocito, C., Fagnoul, D. et al. Evaluation of endothelial damage in sepsis-related ARDS using circulating endothelial cells. Intensive Care Med 41, 231–238 (2015). https://doi.org/10.1007/s00134-014-3589-9

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  • DOI: https://doi.org/10.1007/s00134-014-3589-9

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