Circulating Endothelial Cells From Septic Shock Patients Convert to Fibroblasts Are Associated With the Resuscitation Fluid Dose and Are Biomarkers for Survival Prediction.

Authors:
Pablo Tapia
Pablo Tapia
Universidad Arturo Prat-Centro de Investigaciones del Hombre del Desierto
Chile
Carolina Otero
Carolina Otero
University of Konstanz
Switzerland
Alvaro Becerra
Alvaro Becerra
Centro de Genética Humana (CGH)
Chile
Claudia A Riedel
Claudia A Riedel
Millennium Institute on Immunology and Immunotherapy
Chile
Claudio Cabello-Verrugio
Claudio Cabello-Verrugio
Centro de Regulación Celular y Patología
Chile
Alexis M Kalergis
Alexis M Kalergis
Millennium Institute on Immunology and Immunotherapy
Chile

Crit Care Med 2019 Apr 15. Epub 2019 Apr 15.

Departamento de Ciencias Biologicas, Facultad de Ciencias de la Vida, Universidad Andres Bello, Santiago, Chile.

Objectives: To determine whether circulating endothelial cells from septic shock patients and from nonseptic shock patients are transformed in activated fibroblast by changing the expression level of endothelial and fibrotic proteins, whether the level of the protein expression change is associated with the amount of administered resuscitation fluid, and whether this circulating endothelial cell protein expression change is a biomarker to predict sepsis survival.

Design: Prospective study.

Setting: Medical-surgical ICUs in a tertiary care hospital.

Patients: Forty-three patients admitted in ICU and 22 healthy volunteers.

Interventions: None.

Measurements And Main Results: Circulating mature endothelial cells and circulating endothelial progenitor cells from septic shock and nonseptic shock patients showed evidence of endothelial fibrosis by changing the endothelial protein expression pattern. The endothelial proteins were downregulated, whereas fibroblast-specific markers were increased. The magnitude of the expression change in endothelial and fibrotic proteins was higher in the septic shock nonsurvivors patients but not in nonseptic shock. Interestingly, the decrease in the endothelial protein expression was correlated with the administered resuscitation fluid better than the Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment scores in the septic shock nonsurvivors patients but not in nonseptic shock. Notably, the significant difference between endothelial and fibrotic protein expression indicated a nonsurvival outcome in septic shock but not in nonseptic shock patients. Remarkably, area under the receiver operating characteristic curve analysis showed that endothelial protein expression levels predicted the survival outcome better than the Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment scores in septic shock but not in nonseptic shock patients.

Conclusions: Circulating endothelial cells from septic shock patients are acutely converted into fibroblasts. Endothelial and fibrotic protein expression level are associated with resuscitation fluid administration magnitude and can be used as biomarkers for an early survival diagnosis of sepsis.

Download full-text PDF

Source
http://dx.doi.org/10.1097/CCM.0000000000003778DOI Listing
April 2019

Publication Analysis

Top Keywords

septic shock
32
protein expression
28
shock patients
24
nonseptic shock
24
circulating endothelial
20
endothelial cells
16
resuscitation fluid
16
endothelial fibrotic
16
cells septic
16
endothelial
14
shock
14
endothelial protein
12
patients nonseptic
12
expression change
12
shock nonseptic
12
patients
9
expression
9
nonsurvivors patients
8
better acute
8
acute physiology
8

Altmetric Statistics

Similar Publications