Increase of Soluble RAGE in Cerebrospinal Fluid following Subarachnoid Haemorrhage

Abstract

Receptors for advanced glycation end-products (RAGE) mediate the inflammatory reaction that follows aneurysmal subarachnoid haemorrhage. Soluble RAGE (sRAGE) may function as a decoy receptor. The significance of this endogenous anti-inflammatory mechanism in subarachnoid haemorrhage (SAH) remains unknown. The present study aims to analyse sRAGE levels in the cerebrospinal fluid (CSF) of SAH patients. sRAGE levels were assayed by ELISA kit in 47 CSF samples collected on post-SAH days 0–3, 5–7, and 10–14 from 27 SAH patients with acute hydrocephalus. CSF levels of sRAGE were compared with a control group and correlated with other monitored parameters. In the control group, the CSF contained only a trace amount of sRAGE. By contrast, the CSF of 20 SAH patients collected on post-SAH days 0–3 was found to contain statistically significant higher levels of sRAGE (mean concentration 3.91 pg/mL, p < 0.001). The most pronounced difference in CSF sRAGE levels between good and poor outcome patients was found on days 0–3 post-SAH but did not reach the significance threshold (p = 0.234). CSF sRAGE levels did not change significantly during hospitalisation (p = 0.868) and correlated poorly with treatment outcome, systemic inflammatory markers, and other monitored parameters. Our study revealed an early and constant increase of sRAGE level in the CSF of SAH patients.

Inflammatory Markers in Cerebrospinal Fluid from Patients with Hydrocephalus: A Systematic Literature Review

“…The 22 studies included in the review were cross-sectional, case-control studies. Five studies were prospective [21][22][23][24][25], while two were retrospective [26,27]. The remaining 15 studies did not report whether a prospective or retrospective strategy was performed.…”

“…The remaining 15 studies did not report whether a prospective or retrospective strategy was performed. [21,[23][24][25][26][27][28][29][30][31][32][33][34][35], multiplex immunoassays [35][36][37][38], radioimmunoassays [32], electrochemiluminescence assays [39], a milliplex immunoassay [22], a cytokine antibody microarray kit [40], a quantitative sandwich enzyme immunoassay [41], and a bead-based human inflammatory cytokine kit [42]. Only three studies reported blinding of laboratory staff [21,28,36].…”

“…The sample size of the patient groups included in the review ranged from 2 to 100 individuals. In some of the studies, the small sample size may have reduced the chance of detecting a significant [24,28,34]. In addition to variations related to age-matching, findings presented in the PHH category may have been particularly prone to age variation across studies.…”

“…IVH-related studies, different grading systems and criteria were used in three studies [21,29,31], while two of the four SAH-related studies reported use of a specific grading scale [24,28].…”

CSF proteomics of patients with hydrocephalus and subarachnoid haemorrhage

“…Numerous groups, including our own, have embarked on the analysis of alterations of a variety of proteins in biological fluids with this aim in view. Our previous studies on sTLR 2 and 4 [20], sRAGE [21] and Clusterin [22] in CSF of SAH patients were limited by the methodology, i.e. ELISA assays of proteins preselected as a result of a thorough review of the stroke and neuroinflammatory disease literature.…”