Lymperopoulou Korina, Velissaris Dimitrios, Kotsaki Antigone, Antypa Elli, Georgiadou Sara, Tsaganos Thomas, Koulenti Despina, Paggalou Evgenia, Damoraki Georgia, Karagiannidis Napoleon, Orfanos Stylianos E
2nd Department of Medicine, Sismanogleion General Hospital, Athens, Greece.
Department of Medicine, Patras University Hospital, Patras, Greece.
Cytokine. 2015 May;73(1):163-8. doi: 10.1016/j.cyto.2015.01.022. Epub 2015 Mar 6.
Angiopoietin-2 (Ang-2) is an important mediator in sepsis. We have previously shown that endotoxemia levels are related to the underlying infection and affect septic patients' outcome. Based on this background we now investigated if circulating Ang-2 (cAng-2) and monocyte Ang-2 expression in septic patients are associated with the underlying infection and organ failure. We measured cAng-2 in 288 septic patients (121 with sepsis, 167 with severe sepsis/septic shock) at less than 24h post study inclusion (day 1) and on days 3 and 7. Peripheral blood mononuclear cells (PBMCs) were additionally isolated; Ang-2 gene expression was estimated by means of real-time PCR. Levels of cAng-2 were higher under severe sepsis and septic shock, as compared to uncomplicated sepsis; PBMC Ang-2 copies were higher in severe sepsis. On day 1, cAng-2 and Ang-2 gene copies were greater under severe sepsis/septic shock in sufferers from all types of infections with the exception of community-acquired pneumonia and ventilator-associated pneumonia. cAng-2 increased proportionally to the number of failing organs, and was higher under metabolic acidosis and acute coagulopathy as compared to no failing organ. On day 1, copies of Ang-2 were higher in survivors, whereas cAng-2 was higher in non-survivors. In a large cohort of septic patients, cAng-2 kinetics appears associated with the underlying infection and organ failure type.
血管生成素-2（Ang-2）是脓毒症中的一种重要介质。我们之前已经表明内毒素血症水平与潜在感染相关，并影响脓毒症患者的预后。基于这一背景，我们现在研究脓毒症患者循环中的Ang-2（cAng-2）和单核细胞Ang-2表达是否与潜在感染及器官衰竭相关。我们在纳入研究后不到24小时（第1天）、第3天和第7天测量了288例脓毒症患者（121例脓毒症患者，167例严重脓毒症/脓毒性休克患者）的cAng-2。另外还分离了外周血单个核细胞（PBMC）；通过实时PCR估计Ang-2基因表达。与单纯脓毒症相比，严重脓毒症和脓毒性休克时cAng-2水平更高；严重脓毒症时PBMC的Ang-2拷贝数更高。在第1天，除社区获得性肺炎和呼吸机相关性肺炎外，所有类型感染的严重脓毒症/脓毒性休克患者的cAng-2和Ang-2基因拷贝数更高。cAng-2与衰竭器官的数量成比例增加，与无器官衰竭相比，在代谢性酸中毒和急性凝血病时更高。在第1天，Ang-2拷贝数在幸存者中更高，而cAng-2在非幸存者中更高。在一大群脓毒症患者中，cAng-2动力学似乎与潜在感染和器官衰竭类型相关。
