Clinical significance of circulating endothelial cells in patients with severe sepsis or septic shock

Abstract

Background: Endothelial damage developing in severe sepsis or septic shock results in multiorgan dysfunction. An increased circulating endothelial cell (CEC) count represents a novel marker of endothelial damage, which has been reported in cases of severe sepsis or septic shock. The aim of this study was to evaluate the clinical significance of CECs in patients with severe sepsis or septic shock. Methods: CECs were evaluated and quantified by flow cytometry using plasma collected from patients with severe sepsis or septic shock who were admitted to a medical intensive care unit from February 2011 to August 2011. Results: During the study period, 77 patients were enrolled. The median CEC count was 350 cells/ml (range 0–15 984 cells/ml). There was no significant difference between cases of severe sepsis and septic shock [163 cells/ml (0–15 984 cells/ml) vs 363 cells/ml (0–7884 cells/ml), p = 0.507]. There were no correlations between the number of CECs and inflammatory markers. CEC counts were significantly increased in non-survivors compared to survivors [588.5 cells/ml (1–15 984 cells/ml) vs 292 cells/ml (0–12 882 cells/ml), p = 0.044] within 28 days. The sequential-related organ failure assessment score, CEC counts ≥ 500 cells/ml and blood lactate levels were significantly associated with 28 day mortality. Conclusions: CEC counts were higher in non-survivors of severe sepsis or septic shock and could be used as a biomarker to predict the prognosis in these patients.

Keywords::

• Circulating endothelial cells
• mortality
• septic shock
• severe sepsis

Acknowledgement

We thank Eun-young Jang for technical support.

Declaration of interest: The authors have no conflicts of interest to declare. This study was supported by the Asan Institute for Life Science, Asan Medical Center, Seoul, Korea [grant 11–502].