COVID-19 Hastalarında Serum Endokan Düzeyleri ile Makrofaj Aktivasyon Sendromu Arasındaki İlişki

Yıl 2026, Cilt: 7 Sayı: 1, 33 - 41, 31.01.2026

Mehmet Alptekin Acar , Akif Bayyiğit , Özlem Kandemir Alibakan , Selin Demir , Uğur Çiftçi , Uğur Yılmaz , Mine Adaş , Yücel Arman , Tufan Tükek

https://doi.org/10.47482/acmr.1727140

Öz

Arka plan
Endotel hücrelerine özgü molekül-1 (ESM-1), endokan olarak da bilinir ve endotel disfonksiyonu ile ilişkili bir biyomarkerdir. Bu molekül, öncelikle vasküler endotel hücreleri, distal renal tübülleri kaplayan epitel hücreleri ve bronşların ve akciğerlerin submukozal bezleri tarafından sentezlenir. Bu çalışmanın amacı, enflamatuar süreçlerde rol oynadığı bilinen bu molekül ile COVID-19 ile ilişkili makrofaj aktivasyon sendromu (MAS) arasındaki ilişkiyi araştırmak ve serum endokan düzeylerinin COVID-19 hastalarında mortalite ve klinik ciddiyetin öngörücü bir belirteci olup olmadığını değerlendirmektir.
Yöntemler
Çalışmaya COVID-19 tanısı konmuş toplam 90 hasta dahil edildi. Endokan düzeylerini belirlemek için serum örnekleri toplandı ve bu düzeyler enzim bağlı immünosorbent testi (ELISA) yöntemi kullanılarak ölçüldü. Hastalar, COVID-19 ile ilişkili hiperinflamatuar sendrom (cHIS) skoruna göre iki gruba ayrıldı: Grup 1 (cHIS skoru ≥2) ve Grup 2 (cHIS skoru <2).
Sonuçlar
İki grup arasında serum endokan düzeylerinde istatistiksel olarak anlamlı bir fark yoktu. Ancak, Grup 1, Grup 2'ye kıyasla anlamlı olarak daha düşük lenfosit sayıları (p=0,007) ve anlamlı olarak daha yüksek ferritin, CRP, IL-6, D-dimer, nötrofil/lenfosit oranı, LDH ve glikoz düzeyleri (tümü p<0,001) gösterdi. Hastanede kalış süresi, nötrofil/lenfosit oranı (p<0,001, r=0,464), D-dimer (p=0,014, r=0,277), LDH (p=0,001, r=0,364) ve AST (p=0,005, r=0,312) ile pozitif korelasyon gösterdi .
Sonuç
Serum endokan düzeyleri ile COVID-19 ile ilişkili hiperinflamatuar durumlar arasında anlamlı bir ilişki bulunmamıştır. Endokan ekspresyonunu etkileyebilecek çok sayıda mekanizma göz önüne alındığında, bu biyomarkerin klinik önemini daha iyi anlamak için uzun süreli, çok merkezli ve kontrollü çalışmalar gereklidir.

Anahtar Kelimeler

Makrofaj aktivasyon sendromu , sitokin fırtınası , endokan

The Relationship Between Serum Endocan Levels and Macrophage Activation Syndrome in COVID-19 Patients

Öz

Background: Endothelial cell-specific molecule-1 (ESM-1), also known as endocan, is a biomarker associated with endothelial dysfunction. It is synthesised primarily by vascular endothelial cells, epithelial cells lining the distal renal tubules, and submucosal glands of the bronchi and lungs. The objectives of this study were to investigate the relationship between this molecule, which is known to play a role in inflammatory processes, and macrophage activation syndrome (MAS) associated with COVID-19; and to evaluate whether serum endocan levels are a predictive marker of mortality and clinical severity in COVID-19 patients.
Methods: A total of 90 patients diagnosed with COVID-19 were included in the study. Serum samples were collected to determine endocan levels, which were measured using the enzyme-linked immunosorbent assay (ELISA) method. Patients were divided into two groups based on the COVID-19-associated hyperinflammatory syndrome (cHIS) score: Group 1 (cHIS score ≥2/ low-grade hyperinflammation) and Group 2 (cHIS score <2).
Results: There was no statistically significant difference in serum endocan levels between the two groups. However, Group 1 showed significantly lower lymphocyte counts (p=0.007) and significantly higher levels of ferritin, CRP, IL-6, D-dimer, neutrophil/lymphocyte ratio, LDH, and glucose (all p<0.001) compared to Group 2. Hospital stay duration was positively correlated with the neutrophil/lymphocyte ratio (p<0.001, r=0.464), D-dimer (p=0.014, r=0.277), LDH (p=0.001, r=0.364), and AST (p=0.005, r=0.312).
Conclusion: No significant association was found between serum endocan levels and COVID-19-related hyperinflammatory states. Considering the multiple mechanisms that may influence endocan expression, long-term, multicenter, and controlled studies are required to better understand the clinical significance of this biomarker.

Anahtar Kelimeler

macrophage activation syndrome , cytokine storm , endocan

Etik Beyan

This study was approved by the Health Sciences University (SBU) Prof. Dr. Cemil Taşcıoğlu City Hospital Clinical Research Ethics Committee with decision number 488 on 29.12.2020. Written informed consent was obtained from all participants prior to surgery.

Destekleyen Kurum

No funding was used for the study.

Teşekkür

No acknowledgement for the study.

Kaynakça

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