Soluble T-Cadherin: A Novel Biomarker for Fluid Resuscitation in Burn Patients—A Single-Center Retrospective Observational Study

This single-center retrospective observational study was conducted to investigate whether soluble T-cadherin reflects endothelial injury and predicts fluid requirements in burn patients. The study population included 64 adult patients with ≥20% total body surface area burns who were admitted to the Japan Community Health Care Organization Chukyo Hospital Burn Center (Nagoya, Japan) between 2014 and 2019, as well as 16 healthy individuals as controls. Serum levels of soluble T-cadherin (130 kDa and 100 kDa isoforms) and adiponectin were measured at two phases: Phase 1 (days 1-2) and Phase 2 (days 7-12). Compared to healthy controls, burn patients had significantly lower levels of 100 kDa and 130 kDa soluble T-cadherin ( P < 0.05). In Phase 1, 100 kDa T-cadherin was negatively correlated with 24-hour fluid requirement ( P = 0.01) and plasminogen activator inhibitor-1 levels (an endothelial injury marker). Multivariate regression identified 100 kDa T-cadherin as the sole independent predictor of fluid requirement (estimate: -0.04, P = 0.01). Syndecan-1 was also inversely correlated with 130 kDa T-cadherin. Adiponectin levels in patients and controls did not differ to a statistically significant extent. This is the first study to report reduced circulating levels of soluble T-cadherin in burn patients and its inverse relationship with early fluid resuscitation volume. These findings suggest that 100 kDa T-cadherin may serve as a novel biomarker for endothelial injury and guide individualized fluid management in burn care.