Lower serum endocan levels are associated with the development of acute lung injury after major trauma

• Published in: Journal of critical care Vol. 27; no. 5; pp. 522.e11 - 522.e17
• Main Authors: Mikkelsen, Mark E., MD, MSCE, Shah, Chirag V., MD, MSCE, Scherpereel, Arnaud, MD, PhD, Lanken, Paul N., MD, Lassalle, Philippe, MD, PhD, Bellamy, Scarlett L., ScD, Localio, A. Russell, PhD, Albelda, Steven M., MD, Meyer, Nuala J., MD, Christie, Jason D., MD, MSCE
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-10-2012; Elsevier Limited
• Subjects: Acute lung injury; Acute Lung Injury - epidemiology; Acute respiratory distress syndrome; Adult; Bias; Biomarkers; Blood; Case-Control Studies; Comorbidity; Critical Care; Endothelium; Female; Fractures; Heart rate; Hospitals; Humans; Hypertension; Illnesses; Logistic Models; Male; Middle Aged; Mortality; Neoplasm Proteins - blood; Prognosis; Prospective Studies; Proteoglycans - blood; Studies; Trauma; Variables; Ventilation; Wounds and Injuries - blood; Wounds and Injuries - epidemiology; Acute respiratory distress syndrome; Biomarkers; Acute lung injury; Trauma; Endothelium
• ISSN: 0883-9441; 1557-8615
• DOI: 10.1016/j.jcrc.2011.07.077

Abstract Purpose Endocan is a proteoglycan expressed by endothelial cells in the lung that may inhibit leukocyte recruitment and thus prevent the development of acute lung injury (ALI). We tested the association of serum endocan levels with subsequent development of ALI after major trauma. Materials and Methods This was a single-center nested case-control study within a prospective cohort study of major trauma patients. Using an enzyme-linked immunosorbent assay test, we measured endocan levels from admission serum in 24 controls (no ALI) and 24 cases (ALI within 5 days of trauma). Multivariable logistic regression was used to test the association of admission serum endocan levels with subsequent ALI. Results Patients who developed ALI had lower levels of endocan on admission (mean, 3.5 ± 1.4 ng/mL vs 4.9 ± 2.6 ng/mL in controls; P = .02). For each 1-unit increase in serum endocan level, the odds ratio for ALI development decreased (0.69; 95% confidence interval, 0.49-0.97; P = .03). Lower endocan levels remained associated with a higher incidence of ALI after adjustment for age and illness severity. Conclusions Lower levels of serum endocan on admission are associated with subsequent development of ALI in trauma patients. These observations may be explained by endocan-mediated blockade of leukocyte recruitment in the lung.