Endothelin-1 (ET-1) is an endothelial derived factor that regulates vascular tone and remodeling, induces adhesion molecules in the endothelial wall and adherence of polymorphonuclear cells, and leads to oxidative stress with endothelial damage.(54,55) Although ET-1 levels are usually increased in cardiovascular diseases and sepsis, we did not find such an association or any association with RH-PAT. The gene discussed is EDN1; the disease is Sepsis.