Endothelial glycocalyx degradation and its association with clinical outcomes and host response aberrations in community-acquired pneumonia across different care settings
Authors' conclusion
Glycocalyx degradation, as measured by plasma syndecan-1, shows a non-linear association with mortality in patients with CAP. Key systemic host response changes implicated in sepsis pathogenesis occur prior to detectable glycocalyx degradation in this population.
Study context
- Population
- Patients with community-acquired pneumonia (CAP) on presentation in emergency department (ED), general ward or intensive care unit (ICU)
- Participants
- 384 CAP patients
- Exposure
- Elevated-Syndecan-1 vs Normal-Syndecan-1
- Non-infectious controlsn = 50
- Outcome
- Mortality / survival
- Follow-up
- 30 days
Methodological detailsmultiple care settings (ED, general ward, ICU), blood transcriptomics, Samples from 95 in the ED, 124 after general ward admission, 165 after ICU admission
- Multiple care settings (ED, general ward, ICU)
- Blood transcriptomics
- Samples from 95 in the ED, 124 after general ward admission, 165 after ICU admission
Main finding
As reported in the abstract
30-day survival
- Relationship between syndecan-1 (continuous) and 30-day mortality non-linear and independent of comorbidities and disease severity
- Elevated-Syndecan-1 vs Normal-Syndecan-1: P < 0.05
Observational data: associations, not effects.
Further findings
Host response biomarkers (32 biomarkers, five domains)
- Most biomarkers already strongly elevated in Normal-Syndecan-1 vs non-infectious controls, across all domains
- All biomarkers further increased in Elevated-Syndecan-1, also in direct comparison with Normal-Syndecan-1
Blood leukocyte transcriptome (gene set enrichment analysis)
- Elevated syndecan-1 linked to increased expression of genes for extracellular matrix organization and hemostasis
Original publication
Endothelial glycocalyx degradation and its association with clinical outcomes and host response aberrations in community-acquired pneumonia across different care settings. Crit Care. Published 27 January 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →