Admission angiopoietin levels in children with septic shock

John S. Giuliano, Patrick M. Lahni, Kelli Harmon, Hector R. Wong, Lesley A. Doughty, Joseph A. Carcillo, Basilia Zingarelli, Vikas P. Sukhatme, Samir M. Parikh, Derek S. Wheeler

Research output: Contribution to journalArticlepeer-review

114 Scopus citations


Angiopoietin (angpt) 1 and angpt-2 are circulating proteins first ascribed opposing roles in embryonic angiogenesis. Both bind the tyrosine kinase with immunoglobulin-like loop and epidermal growth factor homology domains (Tie) 2 receptor on endothelial cells, but angpt-1 is a Tie-2 agonist, whereas angpt-2 antagonizes Tie-2 signaling. In the developed vasculature, angpt-1 protects against vascular leak, whereas angpt-2 promotes increased vascular permeability. Because alterations in vascular permeability are common in septic shock, we obtained plasma from critically ill children within 24 h of diagnosis of the systemic inflammatory response syndrome (SIRS, n = 20), sepsis (n = 20), or septic shock (n = 61), as well as 15 healthy controls. Plasma levels of angpt-1 and angpt-2 were measured via a commercially available enzyme-linked immunosorbent assay. Plasma angpt-2 levels were significantly elevated in children with septic shock when compared with healthy children, as well as critically ill children with either SIRS or sepsis, and circulating angpt-2 levels seemed to correlate with disease severity and outcome. In addition, plasma angpt-1 levels were significantly decreased in critically ill children with septic shock compared with critically ill children with either SIRS or sepsis. Given the contrasting effects of angpt-2 and angpt-1 on the vascular endothelium, these two factors may play an important role in the pathophysiology of septic shock in children, and further studies are warranted.

Original languageEnglish (US)
Pages (from-to)650-654
Number of pages5
Issue number6
StatePublished - Dec 2007
Externally publishedYes


  • Angiogenesis
  • Angiopoietin-1
  • Angiopoietin-2
  • Capillary leak
  • Children
  • Endothelial injury
  • Septic shock
  • Tie-2

ASJC Scopus subject areas

  • Emergency Medicine
  • Critical Care and Intensive Care Medicine


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