Endothelial glycocalyx degradation in critically ill foals.

Abstract

BACKGROUND: Endothelial glycocalyx (EG) degradation occurs in septic humans and EG products can be used as biomarkers of endothelial injury. Information about EG biomarkers and their association with disease severity is lacking in hospitalized foals. OBJECTIVES: Measure serum syndecan-1 (SDC-1), heparan sulfate (HS), angiopoietin-2 (ANG-2), aldosterone (ALD), and plasma atrial natriuretic peptide (ANP) concentrations and to determine their association with disease severity and death in hospitalized foals. ANIMALS: Ninety foals &#x2264;3&#x2009;days old. METHODS: Prospective, multicenter, longitudinal study. Foals were categorized into hospitalized (n&#x2009;=&#x2009;74; 55 septic; 19 sick nonseptic) and 16 healthy foals. Serum ([SDC-1], [HS], [ANG-2], [ALD]) and plasma (ANP) were measured over 72&#x2009;hours using immunoassays. RESULTS: Serum ([SDC-1], [HS], [ANG-2], [ALD]) and plasma (ANP) were significantly higher in hospitalized and septic than healthy foals (P&#x2009;<&#x2009;.05). Serum (ANG-2) and plasma (ANP) were significantly higher in hospitalized nonsurvivors than in survivors (P&#x2009;<&#x2009;.05). On admission, hospitalized foals with serum (HS)&#x2009;>&#x2009;58.7&#x2009;ng/mL had higher odds of nonsurvival (odds ratio [OR]&#x2009;=&#x2009;6.1; 95% confidence interval [CI]&#x2009;=&#x2009;1.02-36.7). Plasma (ANP) >11.5&#x2009;pg/mL was associated with the likelihood of nonsurvival in hospitalized foals (OR&#x2009;=&#x2009;7.2; 95% CI&#x2009;=&#x2009;1.4-37.4; P&#x2009;<&#x2009;.05). Septic foals with serum (ANG-2) >1018&#x2009;pg/mL on admission had higher odds of nonsurvival (OR&#x2009;=&#x2009;6.5; 95% CI =1.2-36.6; P&#x2009;<&#x2009;.05). CONCLUSION AND CLINICAL IMPORTANCE: Critical illness in newborn foals is associated with EG degradation and injury, and these biomarkers are related to the severity of disease on admission and the outcome of sick foals.