Angiopoietin-2 (Ang-2) is an important mediator in
sepsis. We have previously shown that
endotoxemia levels are related to the underlying
infection and affect septic patients' outcome. Based on this background we now investigated if circulating Ang-2 (cAng-2) and monocyte Ang-2 expression in septic patients are associated with the underlying
infection and organ failure. We measured cAng-2 in 288 septic patients (121 with
sepsis, 167 with
severe sepsis/
septic shock) at less than 24h post study inclusion (day 1) and on days 3 and 7. Peripheral blood mononuclear cells (PBMCs) were additionally isolated; Ang-2 gene expression was estimated by means of real-time PCR. Levels of cAng-2 were higher under
severe sepsis and
septic shock, as compared to uncomplicated
sepsis; PBMC Ang-2 copies were higher in
severe sepsis. On day 1, cAng-2 and Ang-2 gene copies were greater under
severe sepsis/
septic shock in sufferers from all types of
infections with the exception of community-acquired
pneumonia and
ventilator-associated pneumonia. cAng-2 increased proportionally to the number of failing organs, and was higher under
metabolic acidosis and acute coagulopathy as compared to no failing organ. On day 1, copies of Ang-2 were higher in survivors, whereas cAng-2 was higher in non-survivors. In a large cohort of septic patients, cAng-2 kinetics appears associated with the underlying
infection and organ failure type.