Evaluation of hyaluronic acid as a biomarker of endothelial glycocalyx degradation in sepsis in dogs and cats

Abstract

Sepsis is a complex disease that often results in mortality secondary to a dysregulated and maladaptive host immune response. The endothelial glycocalyx (EG) is responsible for regulating many aspects of this response. Hyaluronic acid (HA) is one of many EG constituents. The EG is damaged in sepsis, causing shedding of these constituents into circulation, serving as quantifiable biomarkers of EG integrity. Damage to the EG occurs with increasing levels of systemic inflammation and can also be caused by hypervolemia. The present research explored daily serum HA concentrations in dogs with septic peritonitis from admission through to recovery. Interactions between HA concentration, cytokine concentrations and total administered daily fluid volume (TADFV) were also explored. Interleukin-6 concentration was a significant predictor of HA concentration, as was TADFV when the patient’s IL-6 concentration was accounted for. The investigators also performed validation of a commercially available human HA enzyme-linked immunosorbent assay for use in feline plasma.