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Commentary

Sepsis and the broken endothelium

Nathan I Shapiro1* and William C Aird2

Author Affiliations

1 Department of Emergency Medicine, Center for Vascular Biology Research, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA

2 Department of Medicine, Center for Vascular Biology Research, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA

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Critical Care 2011, 15:135  doi:10.1186/cc10044


See related research by Yang et al., http://ccforum.com/content/15/1/R11

Published: 21 March 2011

Abstract

The study by Yang and colleagues examined 81 patients with septic shock due to pneumonia, along with 20 patients with pneumonia without organ dysfunction. Their major findings were that circulating levels of soluble vascular endothelial cell growth factor receptor-1 (sVEGFR-1) and urokinase-type plasminogen activator (uPA) were associated with organ dysfunction and mortality, whereas vascular endothelial cell growth factor (VEGF) levels had no such predictive power. Yang and colleagues are to be complimented for a well-conducted study of a reasonably (and helpfully!) homogeneous population of patients with sepsis that carefully and comprehensively analyzed the relationship between sVEGFR-1, uPA, VEGF and clinical outcome. The study serves not only to provide evidence in support of new diagnostic biomarker targets in sepsis, but also to augment the growing evidence of an important role of the endothelium in sepsis in general, and the VEGF signaling axis in particular.