Sepsis and major abdominal surgery lead to flaking of the endothelial glycocalix

Jochen Steppan, Stefan Hofer, Benjamin Funke, Thorsten Brenner, Michael Henrich, Eike Martin, Jürgen Weitz, Ursula Hofmann, Markus A. Weigand

Research output: Contribution to journalArticle

Abstract

Background: Recent evidence suggests that the endothelial glycocalix plays an important role in lethal outcomes following sepsis. We therefore tested if the endothelial glycocalix is shed in patients with sepsis compared with patients after major abdominal surgery and healthy volunteers. Material and Methods: A total of 150 individuals were tested for levels of inflammatory markers (intercellular adhesion molecule-1 [ICAM-1], vascular cell adhesion molecule-1 [VCAM-1], interleukin-6 [IL-6]) and glycocalix markers (syndecan-1, heparan sulfate). Three groups consisted of patients with severe sepsis or septic shock, patients after major abdominal surgery without systemic inflammatory response syndrome, and healthy volunteers. Blood was drawn, at the time of diagnosis or surgery, and 6, 24, and 48 h later. We correlated these markers to each other and to clinically used inflammation markers. Results: Levels of inflammatory markers were markedly higher in patients with sepsis compared with patients after major abdominal surgery and healthy volunteers. After major abdominal surgery, glycocalix markers in human plasma were at levels comparable to patients with sepsis. In patients with sepsis, levels of IL-6 correlated with syndecan-1, ICAM-1, VCAM-1, and lactate, while ICAM-1 furthermore correlated with CRP and lactate levels. Conclusion: High levels of glycocalix markers indicated that significant flaking of the endothelial glycocalix occurred in patients with sepsis, and to a lesser extent in patients after major abdominal surgery. This novel finding could explain the nonspecific capillary leaking syndrome of patients with sepsis and after major abdominal surgery, and may identify new targets for treating those patient populations.

Original languageEnglish (US)
Pages (from-to)136-141
Number of pages6
JournalJournal of Surgical Research
Volume165
Issue number1
DOIs
StatePublished - Jan 2011
Externally publishedYes

Fingerprint

Glycocalyx
Sepsis
Intercellular Adhesion Molecule-1
Syndecan-1
Healthy Volunteers
Vascular Cell Adhesion Molecule-1
Lactic Acid
Interleukin-6
Systemic Inflammatory Response Syndrome
Heparitin Sulfate
Septic Shock

Keywords

  • Glycocalix
  • Heparan sulfate
  • Intercellular adhesion molecule-1
  • Major abdominal surgery
  • Sepsis
  • Syndecan-1
  • Vascular cell adhesion molecule-1

ASJC Scopus subject areas

  • Surgery

Cite this

Steppan, J., Hofer, S., Funke, B., Brenner, T., Henrich, M., Martin, E., ... Weigand, M. A. (2011). Sepsis and major abdominal surgery lead to flaking of the endothelial glycocalix. Journal of Surgical Research, 165(1), 136-141. https://doi.org/10.1016/j.jss.2009.04.034

Sepsis and major abdominal surgery lead to flaking of the endothelial glycocalix. / Steppan, Jochen; Hofer, Stefan; Funke, Benjamin; Brenner, Thorsten; Henrich, Michael; Martin, Eike; Weitz, Jürgen; Hofmann, Ursula; Weigand, Markus A.

In: Journal of Surgical Research, Vol. 165, No. 1, 01.2011, p. 136-141.

Research output: Contribution to journalArticle

Steppan, J, Hofer, S, Funke, B, Brenner, T, Henrich, M, Martin, E, Weitz, J, Hofmann, U & Weigand, MA 2011, 'Sepsis and major abdominal surgery lead to flaking of the endothelial glycocalix', Journal of Surgical Research, vol. 165, no. 1, pp. 136-141. https://doi.org/10.1016/j.jss.2009.04.034
Steppan, Jochen ; Hofer, Stefan ; Funke, Benjamin ; Brenner, Thorsten ; Henrich, Michael ; Martin, Eike ; Weitz, Jürgen ; Hofmann, Ursula ; Weigand, Markus A. / Sepsis and major abdominal surgery lead to flaking of the endothelial glycocalix. In: Journal of Surgical Research. 2011 ; Vol. 165, No. 1. pp. 136-141.
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