Decrease of the plasmatic endocan cleavage ratio is associated with the hyperinflammatory phenotype of acute respiratory distress syndrome
Acute respiratory distress syndrome
Endocan cleavage ratio
Several studies have reported the identification of pro-inflammatory subphenotypes of acute respiratory distress syndrome (ARDS) which seem to be the most likely to respond to targeted treatments, such as restrictive vascular filling, higher PEEP, or statins . In these studies, vasopressor use, low platelets, and low bicarbonate appeared as routine markers of hyperinflammatory ARDS . Endocan and its major catabolite p14 have been reported as novel biomarkers in ARDS , yet their potential utility in the characterization of ARDS phenotypes has never been explored.
We hereby present the results of a post hoc analysis based on the data from a previously published prospective cohort of severe septic patients . Patients with a diagnosis of ARDS within 72 h following enrollment were included in this analysis. We considered ARDS as belonging to the HIP group when the 3 following criteria were present at the time of diagnosis: vasopressor use, platelets < 150 G/L, and bicarbonate < 22 mmol/L . Measurements of endocan and p14 were performed at the time of diagnosis of ARDS and 24 h later if biological samples were available. Plasmatic endocan cleavage ratio (ECR) was calculated as previously described . The aim of this analysis was to assess if static measurements of blood endocan and ECR at time of diagnosis of ARDS, as well as their variations within 24 h, were different between the HIP and NHIP subgroups of ARDS.
These results suggest that the variation of ECR 24 h after the diagnosis of ARDS seems to be a discriminant biomarker to identify hyperinflammatory subphenotypes of ARDS. New studies are warranted to comfort these preliminary observations.
AG and EP conducted data analyses and drafted the manuscript. ND, LP, and SD performed the biological measurements. DM supervised the whole project. All authors read, critically revised, and approved the final manuscript.
The original study was supported by BPI France (grant number BPI 2012-05-336). This funding was attributed to D.M., representing Lille University Hospital. There was no role of the funding body in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript.
Ethics approval and consent to participate
The original study has been approved by the ethics committee of Lille University Hospital (approval number CP03/07). All the participants to this study gave their informed consent prior to enrollment.
Consent for publication
The Endomark H1 and DIYEK C1 ELISA kits used in this study were provided by Lunginnov. P.L. is the cofounder of Lunginnov. N.D. and L.P. are staff members of Lunginnov. The remaining authors declare that they have no competing interests.
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