Studies show that Angiopoietin-2 is a strong predictor in COVID-19 patients
Two research teams find that increased levels of the proinflammatory cytokine Angiopoietin-2 predicts transfer to the ICU and is responsible for hypercoagulation observed in critically ill COVID-patients.
Studies:
Angiopoietin-2 as a marker of endothelial activation is a good predictor factor for intensive care unit admission of COVID-19 patients. Smadja DM et al., Angiogenesis, 2020;1-10. Full text
Elevated Angiopoietin-2 inhibits thrombomodulin-mediated anticoagulation in critically ill COVID-19 patients. Hultstrom M et al., MedRxiv preprint server, 2021. Full text
Click here for a summary of the findings.
Background
SARS-CoV-2 is the causative agent of the coronavirus respiratory disease COVID-19. It has a diverse range of symptoms and may cause severe illness, in particular in patients with cardiovascular risk factors (1).
Endothelial damage and inflammation in SARS-CoV-2 infection
The inflammatory cytokine storm occurring in COVID-19 patients, leads to the recruitment of leukocytes which damage the capillary endothelium. The endothelial damage and inflammation in several organs in SARS-CoV-2 infection is a direct consequence of viral involvement and of the host inflammatory response (2).
Despite the routine thrombosis prophylaxis as standard of care treatment, the major COVID-19 complication is the hyperactivation of the coagulation system indicating a poor prognosis among COVID-19 patients in intensive care (3).
Angiopoietin-2 (ANG2) is a soluble marker of endothelial activation
Angiopoietin-2 is an angiogenesis regulator that can be rapidly released by the activated endothelium upon thrombin or inflammatory cytokines. ANG2 induces inflammation and vascular hyperpermeability and correlates with adverse outcomes in several critical care syndromes (4, 5).
Angiopoietin-2 is a crucial factor to predict transfer to the ICU
In COVID-19 patients, ANG2 was recently reported by Smadja and colleagues to be a relevant factor to predict transfer to the ICU as it was associated with poor lung compliance (6). Thus, showing that endothelial activation reinforces the hypothesis of a COVID-19-associated microvascular dysfunction.
Angiopoietin-2 inhibits anticoagulation in critically ill COVID-19 patients
Hulstrom and colleagues recently demonstrated that ANG2 levels in critically ill COVID-19 patients correlate with disease severity, hypercoagulation, and mortality. In addition, the researchers provided novel in vivo evidence for a direct role for ANG2 in coagulation through binding to and inhibition of thrombomodulin-mediated anticoagulation. The scientists suggest that inhibition of ANG2 might be beneficial for treating critically ill COVID-19 patients, as well as other patients with hypercoagulation (7).
About the Angiopoietin ELISA
- Low sample volume – only 10µl needed
- Assay range optimized for clinical samples
- Ready to use standards and 2 controls included
- Highly specific epitope mapped capture and detection antibodies
The human Angiopoietin-2 ELISA kit was developed and manufactured by Biomedica
Literature
- Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Zhou F et al., Lancet, 2020; 395(10229):1054-1062.
- Endotheliitis in COVID-19. Varga S. Der Pathologe, 2020; 41(Suppl 2):99-102.
- COVID-19 and coagulation: bleeding and thrombotic manifestations of SARS-CoV-2 infection. Al-Samkari H et al., Blood, 2020:136, 489-500.
Role of Angiopoietin-2 in Vascular Physiology and Pathophysiology. Akwii RG et al., Cells, 2019; 8(5): 471. - Circulating angiopoietin-2 and the risk of mortality in patients with acute respiratory distress syndrome: a systematic review and meta-analysis of 10 prospective cohort studies. Li F et al., Therapeutic advances in respiratory disease, 2020; 14, 1753466620905274.
- Angiopoietin-2 as a marker of endothelial activation is a good predictor factor for intensive care unit admission of COVID-19 patients. Smadja DM et al., Angiogenesis, 2020;1-10.
- Elevated Angiopoietin-2 inhibits thrombomodulin-mediated anticoagulation in critically ill COVID-19 patients. Hultstrom M et al., MedRxiv preprint server, 2021.