• Miguel Javier Ugalde, Alberto Caballero, Marta Martín Fernández, Eduardo Tamayo, and Olga de la Varga-Martínez.
• Cuidados intensivos, Hospital Santa Bárbara de Soria, Soria, España. Electronic address: mjugalde@saludcastillayleon.es.
• Med Clin (Barc). 2024 Sep 13; 163 (5): 224231224-231.

IntroductionThe present systematic review analyses the role of soluble fms-like tyrosine kinase-1 (sFLT-1) as an indirect biomarker of endothelial dysfunction in sepsis or septic shock from articles published in PubMed between 2010 and March 2022.Materials And MethodsA systematic review of studies studying sFLT-1 monitoring in intensive care units in adults with sepsis or septic shock vs. controls for sepsis diagnosis and prognosis has been carried out (PROSPERO CRD42023412929 Registry).ResultsThe endothelial dysfunction of sepsis is one of the keys to the development of the disease. VEGF binds to sFLT-1 acting as a competitive inhibitor of VEGF signalling in endothelial cells and thus neutralizes its pro-inflammatory effects. Endothelial dysfunction is reflected in increased sFLT-1 levels. High values of sFLT-1 were used for the differential diagnosis of sepsis versus other inflammatory pathologies, septic shock versus other types of shock, were elevated over time, estimation of disease prognosis, correlation with sepsis severity, organ dysfunction, and mortality prediction.ConclusionsIt is evident that sepsis is based on endothelial dysfunction. sFLT-1 is one of the main biomarkers of microvascular alteration and is a predictive diagnostic and prognostic biomarker.Copyright © 2024 The Author(s). Published by Elsevier España, S.L.U. All rights reserved.

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