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Soluble Vascular Endothelial‐Cadherin Levels in Patients With Sepsis Treated With Direct Hemoperfusion With a Polymyxin B ‐immobilized Fiber Column
Author(s) -
Ebihara Itaru,
Hirayama Kouichi,
Nagai Miho,
Koda Megumi,
Gunji Masanobu,
Okubo Yuki,
Katayama Taisuke,
Sato Chihiro,
Usui Joichi,
Yamagata Kunihiro,
Kobayashi Masaki
Publication year - 2014
Publication title -
therapeutic apheresis and dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.415
H-Index - 53
eISSN - 1744-9987
pISSN - 1744-9979
DOI - 10.1111/1744-9987.12215
Subject(s) - vascular permeability , medicine , hemoperfusion , sepsis , internalization , cadherin , polymyxin b , evans blue , ve cadherin , microcirculation , endothelial activation , endocrinology , immunology , endothelium , receptor , biochemistry , cell , chemistry , hemodialysis , antibiotics
Capillary permeability is a tightly regulated feature of microcirculation in all organ beds; however, in sepsis this feature is fundamentally altered. Several molecules are investigated as associated factors with capillary permeability and vascular endothelial (VE )‐cadherin internalization by vascular endothelial growth factor ( VEGF )‐induced signaling through VEGF receptors leads to increased vascular endothelial cell detachment and trans‐endothelial permeability. We investigated serum soluble VE ‐cadherin levels in septic patients. An enzyme‐linked immunoassay was used to measure serum soluble VE ‐cadherin levels in 47 septic patients treated by direct hemoperfusion with a polymyxin B ‐immobilized fiber column ( DHP‐PMX ). The serum soluble VE ‐cadherin level of septic patients before PMX‐DHP was 3424.1 ± 2033.0 ng/mL, which was significantly lower than that of the controls (5862.0 ± 1521.2 ng/mL; P < 0.0001). The time course of serum soluble VE ‐cadherin levels remained unchanged during PMX‐DHP therapy. There was no significant difference in serum soluble VE ‐cadherin levels before PMX‐DHP therapy between survivors and non‐survivors, and there was no significant difference in those levels between the groups at any time after the initiation of PMX‐DHP therapy. There was no correlation between soluble VE ‐cadherin levels and clinical data, except white blood cell count ( r = −0.277, P = 0.0009). There was no correlation between soluble VE ‐cadherin levels and the levels of angiopoietin 1 and 2. In summary, the relationship between VE ‐cadherin and capillary permeability in sepsis could not be demonstrated. Soluble VE ‐cadherins are not reflected in the balance between intercellular junction plasticity and integrity, but VE ‐cadherin stabilization by its phosphorylation or internalization may be associated with capillary permeability.