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An endothelial dysfunction marker

Endocan is a non-membrane-associated, freely circulating molecule specifically produced by the vascular endothelial cells, exhibiting anti-inflammatory properties. It is encoded by a unique non polymorphic gene called esm1.

Its synthesis and secretion are up-regulated by TNF, IL-1, VEGF or FGF-2. Increase of human plasma endocan levels upon i.v. infusion of LPS correlates a defect of acetylcholine- mediated vasodilatation.

Its synthesis and secretion are down-regulated through activation of endothelial PI3K pathway by a variety of mediators such as gamma interferon or insulin.

Moreover, plasma endocan can decrease through proteolysis induced by activated neutrophils, generating a circulating 14 kDa cathepsin G(CG)-cleaved endocan.

A new clinical concept

This molecule exhibits anti-inflammatory activity, acting as an inhibitor of the leukocyte integrin LFA-1 activation cascade. By preventing the leukocyte entry into the interstitial tissues, endocan reduces inflammation.

Thus, a high endocan blood level in acute or chronic inflammatory syndromes would protect from inflammation, and would be of good prognosis.

Reciprocally, low rates of blood endocan in these syndromes associate with poor prognosis or predict a pathological event.

New clinical applications

Clinical research has proven endocan as a novel biomarker for diagnosing the endothelial response that occurs in many diseases.

Increased or decreased blood endocan identifies patients at risk of lung infection/injury or tumor aggressiveness.

Blood endocan measurement can provide several benefits:

  • Early diagnosis to allow earlier initiation of appropriate management (ARDS, hepatocarcinoma),
  • Risk stratification (pneumoniae),
  • Prediction of clinical outcomes (cirrhosis, oncology),
  • Monitor response to therapy (oncology),
  • Lower hospitalization costs.