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BioMed Research International
Volume 2014, Article ID 985813, 10 pages
http://dx.doi.org/10.1155/2014/985813
Review Article

The Endothelium, A Protagonist in the Pathophysiology of Critical Illness: Focus on Cellular Markers

1Department of Critical Care Medicine, Antwerp University Hospital (UZA), University of Antwerp (UA), Wilrijkstraat 10, 2650 Edegem, Belgium
2Department of Internal Medicine, Antwerp University Hospital (UZA) and University of Antwerp (UA), Wilrijkstraat 10, 2650 Edegem, Belgium
3Laboratory of Cellular and Molecular Cardiology, Antwerp University Hospital (UZA), University of Antwerp (UA), Wilrijkstraat 10, 2650 Edegem, Belgium
4Department of Cardiology, Antwerp University Hospital (UZA), University of Antwerp (UA), Wilrijkstraat 10, 2650 Edegem, Belgium

Received 5 November 2013; Revised 18 February 2014; Accepted 4 March 2014; Published 1 April 2014

Academic Editor: Iveta Bernatova

Copyright © 2014 Sabrina H. van Ierssel et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The endotheliumis key in the pathophysiology of numerous diseases as a result of its precarious function in the regulation of tissue homeostasis. Therefore, its clinical evaluation providing diagnostic and prognostic markers, as well as its role as a therapeutic target, is the focus of intense research in patientswith severe illnesses. In the critically ill with sepsis and acute brain injury, the endothelium has a cardinal function in the development of organ failure and secondary ischemia, respectively. Cellular markers of endothelial function such as endothelial progenitor cells (EPC) and endothelialmicroparticles (EMP) are gaining interest as biomarkers due to their accessibility, although the lack of standardization of EPC and EMP detection remains a drawback for their routine clinical use. In this paper we will review data available on EPC, as a general marker of endothelial repair, and EMP as an equivalent of damage in critical illnesses, in particular sepsis and acute brain injury. Their determination has resulted in new insights into endothelial dysfunction in the critically ill. It remains speculative whether their determination might guide therapy in these devastating acute disorders in the near future.