Biomarkers of endothelial dysfunction predict sepsis mortality in young infants: A matched case-control study

Julie Korol Wright, Kyla Hayford, Vanessa Tran, Gulam Muhammed Al Kibria, Abdullah Baqui, Ali Manajjir, Arif Mahmud, Nazma Begum, Mashuk Siddiquee, Kevin C. Kain, Azadeh Farzin

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Reducing death due to neonatal sepsis is a global health priority, however there are limited tools to facilitate early recognition and treatment. We hypothesized that measuring circulating biomarkers of endothelial function and integrity (i.e. Angiopoietin-Tie2 axis) would identify young infants with sepsis and predict their clinical outcome. Methods: We conducted a matched case-control (1:3) study of 98 young infants aged 0-59 days of life presenting to a referral hospital in Bangladesh with suspected sepsis. Plasma levels of Ang-1, Ang-2, sICAM-1, and sVCAM-1 concentrations were measured at admission. The primary outcome was mortality (n=18); the secondary outcome was bacteremia (n=10). Results: Ang-2 concentrations at presentation were higher among infants who subsequently died of sepsis compared to survivors (aOR 2.50, p =0.024). Compared to surviving control infants, the Ang-2:Ang-1 ratio was higher among infants who died (aOR 2.29, p =0.016) and in infants with bacteremia (aOR 5.72, p =0.041), and there was an increased odds of death across Ang-2:Ang-1 ratio tertiles (aOR 4.82, p =0.013). Conclusions: This study provides new evidence linking the Angiopoietin-Tie2 pathway with mortality and bacteremia in young infants with suspected sepsis. If validated in additional studies, markers of the angiopoietin-Tie2 axis may have clinical utility in risk stratification of infants with suspected sepsis.

Original languageEnglish (US)
Article number118
JournalBMC Pediatrics
Volume18
Issue number1
DOIs
StatePublished - Mar 23 2018
Externally publishedYes

Keywords

  • Angiopoietins
  • Biomarkers
  • Endothelial activation
  • Neonatal Sepsis

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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