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Circulating endothelial progenitor cells inversely associate with organ dysfunction in sepsis

Intensive Care Medicine volume 38, pages 429–436 (2012)Cite this article

Abstract

Purpose

Endothelial dysfunction is a primary contributor to sepsis-related organ dysfunction and death. In sepsis animal models, endothelial progenitor cells (EPC) have contributed to vascular repair. The role of endothelial progenitor cells as a biomarker for organ dysfunction is still unknown. We hypothesized that circulating numbers of endothelial progenitor cells would be associated with improved outcomes in sepsis.

Methods

Prospective, observational single-center cohort study in adult intensive care units at Grady Memorial Hospital, an affiliate of Emory University, from July 2007 through April 2009. Peripheral blood was obtained from 95 patients with sepsis, 37 intensive care unit controls, and 51 healthy controls, of whom only 86 patients with sepsis were used in the analysis because we were not able to obtain enough blood in 9 sepsis patients. Clinical data were obtained, and organ dysfunction was measured by Sepsis-Related Organ Failure Assessment (SOFA) score. Endothelial progenitor cells were assessed by a colony-forming unit (CFU) assay in which peripheral blood mononuclear cells were isolated using Ficoll density-gradient centrifugation and cultured in growth media.

Results

The patients with sepsis had significantly lower mean endothelial progenitor cell colony counts compared with intensive care unit controls (p = 0.035) and healthy controls (p = 0.0005). There was no difference in colony counts between ICU controls and healthy controls (p = 0.81). In the sepsis patients, EPC CFU numbers inversely associated with SOFA score, adjusting for mortality (r 2 = 0.05, p = 0.04).

Conclusion

Increased circulating endothelial progenitor cells inversely correlate with organ dysfunction in sepsis patients.

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Acknowledgments

The authors thank Tina Holden, Judith Schmidt, Joel Andrews, Mona Brown, Edwin Omohwo, Kavita Demla, Elizabeth Ju, Constance Anani, and Jaber El-Bashir for their assistance with patient enrollment, and Susan Gregory and Neeta Shenvi for their assistance with database management.

Funding sources

NIH T32 HL076118, University Research Committee funding from Emory University.

Author information

Affiliations

  1. Division of Pulmonary, Allergy, and Critical Care Medicine, Grady Memorial Hospital, Emory University School of Medicine, 49 Jesse Hill Jr Drive, SE (FOB), Pulmonary, Atlanta, GA, 30303, USA

    Sushma K. Cribbs & Greg S. Martin

  2. Division of Cardiology, Emory University, Atlanta, GA, USA

    Diane J. Sutcliffe & William R. Taylor

  3. Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA

    Mauricio Rojas

  4. Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA

    Kirk A. Easley & Li Tang

  5. Division of Pulmonary, Allergy, and Critical Care Medicine, Emory University, Atlanta, GA, USA

    Kenneth L. Brigham

Authors
  1. Sushma K. Cribbs
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  2. Diane J. Sutcliffe
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  6. Li Tang
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  7. Kenneth L. Brigham
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Correspondence to Sushma K. Cribbs.

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Cribbs, S.K., Sutcliffe, D.J., Taylor, W.R. et al. Circulating endothelial progenitor cells inversely associate with organ dysfunction in sepsis. Intensive Care Med 38, 429–436 (2012). https://doi.org/10.1007/s00134-012-2480-9

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  • DOI: https://doi.org/10.1007/s00134-012-2480-9

Keywords

  • Sepsis
  • Septic shock
  • Endothelium
  • Progenitor cells
  • SOFA
  • Outcomes