Excess circulating angiopoietin-2 levels in sepsis harbinger of death in the intensive care unit.docVIP

Available online /content/13/1/114 Commentary Excess circulating angiopoietin-2 levels in sepsis: harbinger of death in the intensive care unit? John S Giuliano Jr1 and Derek S Wheeler2 1Division of Critical Care Medicine, Department of Pediatrics, Yale University School of Medicine, 333 Ceder St, Yale-New Haven Children’s Hospital, West Pavilion 2nd floor, New Haven, CT 06510, USA 2Division of Critical Care Medicine, Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, 3333 Burnet Avenue, Cincinnati, OH 45229-3039, USA Corresponding author: Derek S Wheeler, derek.wheeler@ Published: 27 January 2009 Critical Care 2009, 13:114 (doi:10.1186/cc7685) This article is online at /content/13/1/114 ? 2009 BioMed Central Ltd See related research by Kümpers et al., /content/12/6/R147 Abstract relatively unexplored. Angpt-1 and angpt-2 appear to have directly opposing roles during health and disease states. Angpt-1 is a Tie-2 agonist and promotes endothelial stabili- zation and quiescence, whereas angpt-2 is a Tie-2 antagonist and promotes endothelial activation, destabilization, and inflammation [3]. As such, the relative balance between angpt-2 and angpt-1 at the Tie-2 receptor may be more relevant to the pathobiology of sepsis than the absolute levels of the individual growth factors [5,6]. The early recognition and management of sepsis remain the challenges in the field of critical care medicine. greatest Endothelial injury is one of the hallmarks of sepsis, leading to capillary leak, microcirculatory dysfunction, organ failure, and eventual death in many critically ill patients. The angiogenic growth factors, angiopoietin (angpt)-1 and angpt-2, act upon the Tie-2 receptor in opposing roles. Angpt-2 has been found in abundance in septic patients when compared with healthy controls.