Observational studyPloS one2017
Endotheliopathy is associated with higher levels of cell-free DNA following major trauma: A prospective observational study.
Observational study in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03682757 (Post-Injury Platelet Biology), which is not on this map. Cited by 22 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Post-Injury Platelet Biology: Mechanisms and Outcomes
Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 45 citations in OpenAlex.
- Predictive value of tachycardia for mortality in trauma-related haemorrhagic shock: a systematic review and meta-regression.BMJ open · 2022Pooled it
- Pre-hospital plasma in haemorrhagic shock management: current opinion and meta-analysis of randomized trials.World journal of emergency surgery : WJESPooled it
- Prehospital plasma is associated with distinct biomarker expression following injury.JCI insight · 2020Trial
- Circulating Clues in Ménière's Disease: Elevated Cell-Free DNA and a Pro-Inflammatory Signature in Patients' Blood.International journal of molecular sciences · 2026Article
- Day One Cell-Free DNA Levels as an Objective Prognostic Marker of Mortality in Major Burns Patients.Cells · 2025Article
- Cytosolic nucleic acid sensing as driver of critical illness: mechanisms and advances in therapy.Signal transduction and targeted therapy · 2025Review
- Extracted Plasma Cell-Free DNA Concentrations Are Elevated in Colic Patients with Systemic Inflammation.Veterinary sciences · 2024Article
- The Polyanionic Drug Suramin Neutralizes Histones and Prevents Endotheliopathy.Journal of immunology (Baltimore, Md. : 1950) · 2023Article
- Circulating cell-free DNA in health and disease - the relationship to health behaviours, ageing phenotypes and metabolomics.GeroScience · 2023Article
- Investigation of plasma cell-free DNA as a potential biomarker in horses.Journal of veterinary diagnostic investigation : official publication of the American Association of Veterinary Laboratory Diagnosticians, Inc · 2022Article
- Clinical and biological determinants of circulating tumor DNA detection and prognostication using a next-generation sequencing panel assay.Cancer biology & therapy · 2021Article
- Endothelial cell regulation of systemic haemodynamics and metabolism acts through the HIF transcription factors.Intensive care medicine experimental · 2021Article
- Bosutinib reduces endothelial permeability and organ failure in a rat polytrauma transfusion model.British journal of anaesthesia · 2021Article
- Review
- Total and endothelial cell-derived cell-free DNA in blood plasma does not change during menstruation.PloS one · 2021Article
- The Impact of Pre-transplant Cell-free DNA Levels on Leukemia Relapse and Transplant-related Complications in Allogeneic Hematopoietic Stem Cell Transplant RecipientsBalkan medical journal · 2020Article
- Dysregulation of the actin scavenging system and inhibition of DNase activity following severe thermal injury.The British journal of surgery · 2020Article
- In vitro endothelial hyperpermeability occurs early following traumatic hemorrhagic shock.Clinical hemorheology and microcirculation · 2020Article
- Machine learning for the detection of early immunological markers as predictors of multi-organ dysfunction.Scientific data · 2019Article
- Noninvasive detection of graft injury after heart transplant using donor-derived cell-free DNA: A prospective multicenter study.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2019Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCell free deoxyribonucleic acid (cfDNA) has been proposed as a biomarker of secondary complications following trauma. Raised thrombomodulin and syndecan-1 levels have been used to indicate endotheliopathy, and are associated with inflammation, coagulopathy, and mortality. The current study aimed to analyse the association between cfDNA and biomarkers of endotheliopathy in a cohort of trauma patients, and whether raised levels of cfDNA were associated with poorer clinical outcomes.
methodsSerum thrombomodulin and syndecan-1 were used as biomarkers of endotheliopathy and compared to plasma cfDNA in trauma patients from two prospective longitudinal observational studies. Cohort A (n = 105) had a predicted injury severity score (ISS) >8, and had blood sampled within 1h of injury and at 4-12h. Cohort B (n = 17) had evidence of haemorrhagic shock, and had blood sampled at a median time of 3.5h after injury. Relationships between biomarkers were tested using multivariable linear regression models that included the covariates of gender, age, ISS, Glasgow Coma Scale, lactate, systolic blood pressure, and heart rate. A model was fitted to investigate whether changes in cfDNA were associated with similar changes in endothelial biomarkers.
resultsThe mean age was 41 (SD 19), and the median ISS was 25 (IQR 12-34). There was a significant association between cfDNA levels and both syndecan-1 and thrombomodulin levels (both p<0.001). This was independent of all covariates except for ISS, which significantly correlated with cfDNA levels. 50 ng/ml change in syndecan-1 and 1 ng/ml change in thrombomodulin corresponded to 15% and 20% increases in cfDNA levels respectively (both p<0.001). Patients who died had significantly higher prehospital and in-hospital cfDNA levels (both p<0.05).
conclusionsRaised cfDNA levels are associated with markers of endotheliopathy following trauma, and are associated with mortality. This relationship is present within the first hour of injury, and a change in one biomarker level is reflected by similar changes in the others. These findings are in keeping with the hypothesis that circulating DNA and endothelial injury share a common pathway following trauma.
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Registered trials
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