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Endocan & pulmonary inflamation

The lungs naturally receive a large flow of blood. Many leukocytes pass through the lungs, but do not cross the underlying tissues. To keep these leukocytes into the bloodstram, endothelial cells that line the inner wall of blood vessels produce mediators like endocan that prevent the leukocytes from spontaneously migrating into the alveolus.

Endocan is neosynthesized by the pulmonary endothelium in response to proinflammatory stimuli. It is completely secreted in free form in the bloodstream. Its apparent molecular weight of 400 kDa due to the presence of a glycosaminoglycan chain prevents its filtration through the kidney glomerular barrier. This makes endocan an excellent biomarker able to provide information on the inflammatory state of the deep lung (see table below).

Predicted respiratory event

Diagnostic value
Pathological contextSource PubMed
Respiratory failureAbnormal low blood endocan. Dealyed pulmonary responsePolytrauma, sepsis, COVID ?PubMed studies
Severity of pneumoniaAbnormal high blood endocan. Increased pulmonary responsecommunity-acquired pneumoniaPubMed studies
Posptoperative pneumoniaAbnormal high blood endocan after surgery. Increase pulmonary response.Cardiac surgeryPubMed studies
Nosocomial pneumoniaINcreasing blood endocan. Increased pulmonary responseMechanically ventilated patientPubMed studies
SeverityAbnormal high blood endocanSleep apnea syndromePubMed studies

Endocan and tumor angiogenesis

Endocan is also neosynthesized during angiogenesis in response to angiogenic mediators such as VEGF. Endocan is preferentially expressed in specialized endothelial cells called tip-cells, found at the growing end of a nascent vascular sprout and are characterized by abundant and dynamic filopodia. Endocan promotes vascular sprouting in the presence of VEGF. This makes endocan an excellent marker of tumor angiogenesis, which has been particularly studied in hepatocarcinoma and gastric cancer.

Predicted event
Diagnostic valuePathologic contextPubMed studies
Early recurrenceExpression in tumor vessels Endocan Positive/negative on pre-therapuetic liver biopsy. Se : 95% (42/44) – Sp : 92% (13/155) VPP : 76% – VPN : 99%Suspicion of hepato carcinoma.PubMed studies
AggressionExpression in tumor vessels and in tumor cells. Endocan positive on gastric bipsy. Abnormal elevated plasma endocanGastric CancerPubMed studies
Poor prognosisOne of the genes of a poor prognosisBreats cancerPubMed studies
Poor prognosisExpression in tumor vesselsKidney CancerPubMed studies
Poor prognosisExpression in tumor vesselsBladder CancerPubMed studies
High gradeExpression plaisadic tuors cellsBrain CancerPubMed studies
Poor prognosisExpression in tumor vesselsLung CancerPubMed studies
Poor prognosisExpression in tumor vesselsColon CancerPubMed studies

Endocan & vascular syndromes

Finally, variations of blood endocan levels are observed in various pathologies where endothelial dysfunction is associated, such as proliferative retinopathy or early severe preeclampsia..

Predicted eventDiagnotic valuePathophysiological contextPubMed studies
Early severe preeclampsiaAbonromaly low level in the 3rd month of gestation. POssible indicatio of low dose aspirinEnd of the first trimester gestationPubMed studies
Digestive graft versus host reactionAbnormaly low blood level before transplantationBone marrowPubMed studies
Proliferative retinopathyAbnormal high vitreous countRétinopathie diabétiquePubMed studies
Poor prognosisAbnormal high blood levelCirrhosisPubMed studies