Endocan Levels Can Predict Cardiovascular Involvement in Patients with Sarcoidosis

Levels of endocan, an indicator of inflammation, can be used as a predictive biomarker for the involvement of the cardiovascular system and the development of atherosclerosis in patients with sarcoidosis, a new study shows.

The study titled, “Endocan Levels and Endothelial Dysfunction in Patients With Sarcoidosis,” was published in the journal Angiology.

Sarcoidosis is an inflammatory disease that generally affects the lungs and lymph nodes, but may also affect other organs including the heart. While sarcoidosis is generally not a fatal condition, it can have a severe negative impact on the cardiovascular system.

Endothelial dysfunction occurs as a result of injury to endothelial cells, which form the lining of blood vessels. Endothelial dysfunction is a trigger for the development of atherosclerosis, a disease in which plaque builds up inside blood vessels, often leading to blood-flow blockage.

Sarcoidosis patients can develop a number of different cardiovascular conditions. Lesions on the myocardium, or heart muscle, are seen in 20-30 percent of sarcoidosis patients, and atherosclerotic changes are seen with increasing severity and duration of the disease.

Inflammation is the primary cause of endothelial dysfunction and atherosclerosis. Endothelial cell-specific molecule 1 (endocan) – a compound that is produced by endothelial cells – is upregulated in inflammatory diseases with endothelial dysfunction.

Hence, endocan levels could serve as a potential marker for endothelial dysfunction in patients with sarcoidosis. However, the relationship between endocan and sarcoidosis had never been explored.

So, researchers set out to determine whether levels of endocan can reflect cardiovascular involvement and endothelial dysfunction in patients with sarcoidosis.

The study included 53 patients with sarcoidosis without conventional cardiovascular risk factors and 40 healthy controls.

Results showed that patients with sarcoidosis had significantly higher endocan levels (an average of 306 ng/mL) compared to patients without sarcoidosis (an average of 269 ng/mL).

Researchers then used a test called brachial artery flow-mediated dilation (FMD) — a widely accepted method for evaluating endothelial function — to group patients based on evidence of endothelial dysfunction.

Patients with sarcoidosis were found to have lower FMD scores, which is indicative of higher endothelial dysfunction, compared to individuals in the healthy group.

Statistical analysis showed that a negative correlation exists between endocan levels and FMD in patients with sarcoidosis. This means that patients with higher levels of endothelial dysfunction are also more likely to have higher levels of endocan.

Thus, the team concluded that “sarcoidosis is associated with high levels of endocan and lower FMD values, which may indicate endothelial dysfunction and an early stage of atherosclerosis.”

They added that “increased endocan levels may be a predictive marker of vascular involvement and subclinical atherosclerosis in patients with sarcoidosis.”