• Geerten P van Nieuw Amerongen and A B Johan Groeneveld.
• Department of Physiology, Institute for Cardiovascular Research, Vrije Universiteit Medical Centre, 1081 HV Amsterdam, The Netherlands.
• Crit Care. 2010 Jan 1;14(3):166.

AbstractThe interesting study by Davis and colleagues in the current issue of Critical Care expands on the increasingly recognized role of angiopoietins in human sepsis but raises a number of questions, which are discussed in this commentary. The authors describe an association between elevated angiopoietin (ang)-2 levels and impaired vascular reactivity, measured by the partly nitric oxide-dependent finger hyperemic response to forearm vascular occlusion, in patients with sepsis. This suggests that the ang-1/2-Tie2 system is involved in a number of pathophysiologic, phenotypic and perhaps prognostic alterations in human sepsis, on top of the effect on pulmonary endothelial barrier function. The novel inflammatory route may be a target for future therapeutic studies in human sepsis and acute lung injury, including those with activated protein C.

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