Soluble form of the receptor for advanced glycation end products is a marker of acute lung injury but not of severe sepsis in critically ill patients.

Soluble form of the receptor for advanced glycation end products is a marker of acute lung injury but not of severe sepsis in critically ill patients.

MedLine Citation:	PMID: 21220996 Owner: NLM Status: MEDLINE
Abstract/OtherAbstract:	OBJECTIVES: Levels of the soluble form of the receptor for advanced glycation end products (sRAGE) are elevated during acute lung injury. However, it is not known whether this increase is linked to its involvement in alveolar epithelium injury or in systemic inflammation. Whether sRAGE is a marker of acute lung injury and acute respiratory distress syndrome, regardless of associated severe sepsis or septic shock, remains unknown in the intensive care unit setting. DESIGN: Prospective, observational, clinical study. SETTING: Intensive care unit of an academic medical center. PATIENTS: A total of 64 consecutive subjects, divided into four groups: acute lung injury/acute respiratory distress syndrome (n=15); acute lung injury/acute respiratory distress syndrome plus severe sepsis/septic shock (n=18); severe sepsis/septic shock (n=16); and mechanically ventilated controls (n=15). INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Plasma sRAGE levels were measured at baseline and on days 3, 6, and 28 (or at intensive care unit discharge, whichever occurred first). Baseline plasma levels of sRAGE were significantly higher in patients with acute lung injury/acute respiratory distress syndrome, with (median, 2951 pg/mL) or without (median, 3761 pg/mL) severe sepsis, than in patients with severe sepsis (median, 488 pg/mL) only and in mechanically ventilated controls (median, 525 pg/mL). Levels of sRAGE were correlated with acute lung injury/acute respiratory distress syndrome severity and decreased over time but were not associated with outcome. Lower baseline plasma sRAGE was associated with focal loss of aeration based on computed tomography lung morphology. CONCLUSIONS: sRAGE levels were elevated during acute lung injury/acute respiratory distress syndrome, regardless of the presence or absence of severe sepsis. The plasma level of sRAGE was correlated with clinical and radiographic severity in acute respiratory distress syndrome patients and decreased over time, suggesting resolution of the injury to the alveolar epithelium. Further study is warranted to test the clinical utility of this biomarker in managing such patients and to better understand its relationship with lung morphology during acute lung injury/acute respiratory distress syndrome.

Authors:	Matthieu Jabaudon; Emmanuel Futier; Laurence Roszyk; Elodie Chalus; Renaud Guerin; Antoine Petit; Segolene Mrozek; Sebastien Perbet; Sophie Cayot-Constantin; Christian Chartier; Vincent Sapin; Jean-Etienne Bazin; Jean-Michel Constantin
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Publication Detail:	Type: Journal Article; Research Support, Non-U.S. Gov't
Journal Detail:	Title: Critical care medicine Volume: 39 ISSN: 1530-0293 ISO Abbreviation: Crit. Care Med. Publication Date: 2011 Mar
Date Detail:	Created Date: 2011-02-18 Completed Date: 2011-04-06 Revised Date: 2012-01-26
Medline Journal Info:	Nlm Unique ID: 0355501 Medline TA: Crit Care Med Country: United States
Other Details:	Languages: eng Pagination: 480-8 Citation Subset: AIM; IM
Affiliation:	Department of Anesthesiology and Critical Care Medicine, Intensive Care Unit, Estaing University Hospital, CHU Clermont-Ferrand, Clermont-Ferrand, France. mjabaudon@chu-clermontferrand.fr
Data Bank Information
Bank Name/Acc. No.:	ClinicalTrials.gov/NCT00811629
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MeSH Terms
Descriptor/Qualifier:	Academic Medical Centers Acute Lung Injury / blood, pathology Aged Biological Markers / blood Critical Illness Female Glycosylation End Products, Advanced / blood* Humans Intensive Care Units Lung / pathology Male Middle Aged Prospective Studies Respiration, Artificial Respiratory Distress Syndrome, Adult / blood Sepsis / blood*, pathology Shock, Septic / blood Statistics, Nonparametric
Chemical
Reg. No./Substance:	0/Biological Markers; 0/Glycosylation End Products, Advanced
Comments/Corrections
Comment In:	Crit Care Med. 2012 Jan;40(1):354; author reply 354-5 [PMID: 22179381 ] Crit Care Med. 2011 Mar;39(3):589-90 [PMID: 21330859 ]

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