The diagnostic utility and tendency of the soluble receptor for advanced glycation end products (sRAGE) in exudative pleural effusion

Abstract

Background:The soluble receptor for advanced glycation end products (sRAGE) may have an inflammatory or homeostatic function in lung tissue. The aim of this study was to assess the usefulness of sRAGE as a diagnostic marker for exudative pleural effusions, which are common manifestations of a variety of diseases. Methods:Patients with an undiagnosed pleural effusion were prospectively enrolled between January 2013and January 2015. Samples of blood and pleural fluid were centrifuged and the supernatant stored at −70 °C.The levels of sRAGE in serum and pleural fluid were determined using a commercially available enzymelinked immunosorbent assay (ELISA) kit. Results:In total 47 patients, 21 patients were diagnosed with a tuberculous effusion, and the groups diagnosed with parapneumonic or malignant effusions comprised 13 patients each. The serum sRAGE levels for tuberculosis were significantly elevated [median, 1,291 pg/mL; interquartile range (IQR), 948-1,711 pg/mL] when compared with those for both pneumonia (median, 794 pg/mL; IQR, 700-1,255 pg/mL) and lung cancer (median, 886 pg/mL; IQR, 722-1,285 pg/mL) (P=0.029). The pleural sRAGE levels for pneumonia (median, 1,763 pg/mL; IQR, 1,262-4,431 pg/mL) were lower than those for both tuberculosis (median, 5,081 pg/mL; IQR, 3,300-6,004 pg/mL) and lung cancer (median, 4,936 pg/mL; IQR, 3,282-7,018 pg/mL) (P=0.009) The receiver operating characteristic (ROC) curve analysis selected 896 pg/mL as the best cutoff value in the sRAGE serum level for tuberculosis [sensitivity, 86%; specificity 58%; area under the curve (AUC) =0.727, P=0.008]. For the pleural effusion sRAGE level, the ROC curve analysis selected 2,231 pg/mL as the best cutoff value for pneumonia (sensitivity, 91%; specificity, 62%, AUC =0.792, P=0.002).Conclusions: Among patients with exudative effusion, pleural and serum sRAGE measurements may be useful supportive diagnostic tools in the evaluation of ambiguous pleural effusion. Furthermore, the behavior of sRAGE in the serum and pleural fluid of various pulmonary diseases suggests that sRAGE may be linked to the chronic process of lung damage and inflammation rather than acute bacterial infection.

Reduced Circulating Soluble Receptor for Advanced Glycation End-products in Chronic Hepatitis B Are Associated with Hepatic Necroinflammation

“…The present study demonstrated that there was no signi cant difference among CHB patients with different viral loads, which was con rmed in the three subgroups with high viral loads HBeAg(-) IR phase, HBeAg(+) IT phase and HBeAg(+) IA phase. These ndings indicate that sRAGE may not be a factor of the host innate defense system that participates in HBV replication, consistent with a previous report showing that serum sRAGE levels were linked to the chronic in ammation in lung disease rather than pathogen infection [24].…”

ANA positivity and complement level in pleural fluid are potential diagnostic markers in discriminating lupus pleuritis from pleural effusion of other aetiologies

“… 10 12 13 28 A previous study reported lower levels of pleural fluid sRAGE in patients with bacterial pneumonia compared with those with tuberculosis or lung cancer. 29 We only observed a trend of higher levels of pleural fluid sRAGE with lupus pleuritis when compared with malignant pleural effusion.…”

“…10 12 13 28 A previous study reported lower levels of pleural fluid sRAGE in patients with bacterial pneumonia compared with those with tuberculosis or lung cancer. 29 We only observed a trend of higher levels of pleural fluid ADA catalyses the deamination of adenosine, which is a crucial suppressor of the inflammation. 30 Moreover, Lupus Science & Medicine ADA is involved in the differentiation and maturation of the immune cells such as lymphocytes.…”

Anti-Viral and Anti-Inflammatory Therapeutic Effect of RAGE-Ig Protein Against Multiple SARS-CoV-2 Variants of Concern Demonstrated in K18-hACE2 Mouse and Syrian Golden Hamster Models

“…The RAGE pathway has been reported in the pathogenesis of lung diseases such as chronic obstructive pulmonary disease (COPD), interstitial lung diseases, and ARDS (9,10). In recent years, the therapeutic intervention of the RAGE pathway has been demonstrated to benefit patients suffering from ARDS, COPD, pulmonary fibrosis, and other pathologies associated with the pulmonary system (11)(12)(13)(14)(15). Notably, enhanced levels of RAGE ligands are associated with inflammatory disorders Fields (16)(17)(18), such as diabetes or other chronic inflammatory disorders.…”