Exploring the role of flow cytometry to assess endothelial cells in human sepsis: A systematic review.

Abstract

Introduction: Given the key role of the endothelium in organ failure secondary to sepsis, we reviewed the available literature on the use of flow cytometry (FC) to analyse endothelial cells in human sepsis.

Methods: We systematically searched PubMed and Web of Science from inception until November 2024 to identify original research articles describing the use of FC to study human endothelial cells in sepsis.

Results: A total of 395 original articles were found; 36 met the inclusion criteria. Ten studied circulating mature (CEC) or progenitor (CEPC) endothelial cells. High CEC and/or CEPC counts correlated with higher mortality; CEC numbers were increased even before the onset of shock. Twenty-six manuscripts studied the phenotype of different human microvascular endothelial cells (HMEC), and showed that expression of adhesion molecules ICAM-1, VCAM-1 and E-selectin were increased in sepsis, but there was no evidence of their association with severity or mortality.

Conclusion: High CEC and CEPC counts correlate with sepsis severity and mortality, confirming that their assessment by FC can shed some light on early sepsis diagnosis.