Receptor for advanced glycation end-products and ARDS prediction: a multicentre observational study

Abstract

Acute respiratory distress syndrome (ARDS) prediction remains challenging despite available clinical scores. To assess soluble receptor for advanced glycation end-products (sRAGE), a marker of lung epithelial injury, as a predictor of ARDS in a high-risk population, adult patients with at least one ARDS risk factor upon admission to participating intensive care units (ICUs) were enrolled in a multicentre, prospective study between June 2014 and January 2015. Plasma sRAGE and endogenous secretory RAGE (esRAGE) were measured at baseline (ICU admission) and 24 hours later (day one). Four AGER candidate single nucleotide polymorphisms (SNPs) were also assayed because of previous reports of functionality (rs1800625, rs1800624, rs3134940, and rs2070600). The primary outcome was ARDS development within seven days. Of 500 patients enrolled, 464 patients were analysed, and 59 developed ARDS by day seven. Higher baseline and day one plasma sRAGE, but not esRAGE, were independently associated with increased ARDS risk. AGER SNP rs2070600 (Ser/Ser) was associated with increased ARDS risk and higher plasma sRAGE in this cohort, although confirmatory studies are needed to assess the role of AGER SNPs in ARDS prediction. These findings suggest that among at-risk ICU patients, higher plasma sRAGE may identify those who are more likely to develop ARDS.

Driving pressure and acute respiratory distress syndrome in critically ill patients

“…This is a secondary analysis of a prospective multicentre observational study. Data used in this ancillary study were prospectively obtained from patients previously enrolled in a large multicentre observational study of the predictive values of RAGE (the receptor for advanced glycation end‐products) isoforms and gene variants for the onset of ARDS (PrediRAGE study) . Between June 2014 and January 2015, 500 critically ill adult patients in whom at least one ARDS risk factor was identified were enrolled.…”

“…Because most patients with ARDS are identified within 7 days of recognition of the underlying risk factor(s), we postulated that ΔP could be a risk predictor for ARDS development in patients without ARDS but with at least one ARDS risk factor upon admission to the intensive care unit (ICU). To assess this association, we did a secondary analysis of individual patient data that were prospectively obtained during a large multicentre observational study …”

Clinical and Biological Predictors of Plasma Levels of Soluble RAGE in Critically Ill Patients: Secondary Analysis of a Prospective Multicenter Observational Study

“…Data used in this ancillary study were prospectively obtained from patients previously enrolled in a large multicenter observational study on the predictive values of RAGE isoforms and gene variants for the onset of ARDS (PrediRAGE study, clinicaltrials.gov identifier: NCT02070536 ) [ 28 ]. Between June 2014 and January 2015, 500 critically ill adult patients admitted to five intensive care units (ICUs) were enrolled in the primary study if they had at least one ARDS risk factor [ 14 ].…”

Recombinant Human Thrombomodulin for Pneumonia-Induced Severe Acute Respiratory Distress Syndrome Complicated by Disseminated Intravascular Coagulation in Children: A feasibility study

“…However, respiratory conditions did not improve after rTM in the patients who died. Recently, Jabaudon et al reported that a higher baseline level of sRAGE was associated with development of ARDS [22]. In this study, on day X (just before administration of rTM), the plasma concentrations of sRAGE in patients 5 and 6, who later died, were 4715 and 8501 pg/mL, respectively, whereas the median concentration of sRAGE in the patients who survived was 1817 [IQR 1437-1904] pg/m.…”