Ang-2 is a novel marker of endothelial dysfunction and inflammation. Ang-2 is released from endothelial cells upon stimulation and exerts its effect via the endothelial-specific Angiopoietin-Tie ligand-receptor system. Ang-2 destabilizes endothelial barrier function and acts as pro-inflammatory molecule. It is therefore, an interesting molecule to study in the context of vascular leakage syndromes, such as sepsis and SIRS and has received considerable attention in human medicine as a diagnostic and prognostic marker and a potential treatment target. The aim of this study was to assess Ang-2 concentrations in plasma of canine patients with SIRS with and without sepsis and to examine whether this parameter correlates with disease severity and outcome. Ethical approval was obtained for the study protocol. Plasma was collected from healthy dogs (n=18), and dogs with SIRS (n=31) with or without sepsis (n=28) presented to a veterinary referral hospital. Dogs were included into the SIRS group if they fulfilled the SIRS criteria by Hauptmann JG et al. (1997) at admission. Dogs were considered septic if an underlying bacterial infection was identified. The APPLE₅ score, a five-variable model based on glucose, albumin, mentation score, platelet count, and lactate, was used as an objective measure of disease severity. Plasma Ang-2 was measured using a previously validated commercial human Ang-2 ELISA. Ang-2 was compared between healthy dogs and dogs with SIRS with or without sepsis, as well as between survivors and non-survivors using the Kruskal-Wallis Test. Correlations between Ang-2 and other clinically relevant parameters including C-reactive protein (CRP), white blood cell count and bilirubin were determined using linear regression analysis. There was no significant difference between groups with regards to age, sex, and breed distribution. Median Ang-2 was significantly higher in dogs with SIRS (16.2; ICR, 8.9–34.5 ng/ml) and sepsis (21.1; ICR, 15.1–29.8 ng/ml) compared to healthy dogs (8.0; ICR, 6.7–10.7 ng/ml). Ang-2 was significantly higher in non-survivors (24.1; ICR, 11.9–50.0 ng/ml) than dogs alive at discharge (11.0; ICR, 7.5–21.5 ng/ml). Dogs with an APPLE₅ score ≤25 (low severity grade) had significantly lower Ang-2 levels compared to dogs with an APPLE₅ score >25 (high severity grade). Plasma Ang-2 did not correlate with CRP, white blood cell count, or bilirubin. Ang-2 may represent a useful additional prognostic marker in dogs with SIRS with or without sepsis.

Disclosures

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