Circulating syndecans during critical illness

Area of Science:

• Biochemistry
• Critical Care Medicine
• Biomarker Discovery

Background:

• Circulating syndecans are implicated as markers of glycocalyx degradation.
• Previous studies noted elevated syndecan-1 in various pathological conditions.
• The role of other syndecan subtypes during critical illness remains less understood.

Purpose of the Study:

• To investigate alterations in plasma levels of syndecan-2, -3, and -4 during critical illness.
• To compare these levels with syndecan-1.
• To assess the association of syndecan levels with mortality in intensive care unit (ICU) patients.

Main Methods:

• Plasma levels of syndecan-1, -2, -3, and -4 were quantified using ELISA.
• 137 consecutive ICU patients across various critical conditions (sepsis, cardiac arrest, etc.) were included.
• Levels were compared among patient groups and with healthy controls.

Main Results:

• Syndecan-1 and syndecan-3 levels were elevated in ICU patients compared to controls and similar across different critical illness groups.
• No significant differences in plasma levels of syndecan-2 or syndecan-4 were observed among patient groups or compared to controls.
• All measured syndecans (syndecan-1, -2, -3, -4) demonstrated an association with mortality.

Conclusions:

• Critical illness, regardless of the specific condition, triggers the release of syndecan-1 and syndecan-3.
• Syndecan-1 and syndecan-3 levels are elevated and correlate with each other in critically ill patients.
• Syndecan-1 and syndecan-3 may serve as general biomarkers of critical illness and glycocalyx integrity, with prognostic value for mortality.