The soluble receptor for advanced glycation end products can prospectively identify patients at greatest risk for preterm birth

Bastek, Jamie A.; Brown, Amy G.; Foreman, Markley N.; McShea, Meghan A.; Anglim, Laura; Adamczak, Joanna E.; Elovitz, Michal A.

doi:10.3109/14767058.2012.663825

Cited by 17 publications

(15 citation statements)

References 48 publications

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“…Before further analyses were performed, thymus measurements that might reflect a small, or involuted, thymus were identified. Dividing continuous data into quartiles to facilitate analysis is an accepted statistical practice, 33 which has been performed in the obstetric 34,35 and cardiovascular 36 literature. Once such dichotomization of each thymus parameter had been performed, multivariable logistic regression was repeated to determine the association between each thymus measurement as a dichotomous variable (small versus not small) and the primary and secondary outcomes.…”

Section: Methodsmentioning

confidence: 99%

Second‐Trimester Sonographic Thymus Measurements Are Not Associated With Preterm Birth and Other Adverse Obstetric Outcomes

Brandt

Bastek

Wang

et al. 2016

J of Ultrasound Medicine

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reterm birth, which is defined as delivery before 37 weeks' gestation, is responsible for 35% of deaths in the first year of life and more than $26 billion in annual health care costs. 1 Current methods for identifying women at increased risk for preterm birth are inadequate. Although universal cervical length screening during the second-trimester anatomic survey may identify patients at risk for spontaneous preterm birth, many patients with normal second-trimester cervical length measurements will still have preterm birth. [2][3][4] Justin S. Brandt, MD, Jamie A. Bastek, MD, MSCE, Eileen Wang, MD, Stephanie Purisch, MD, Nadav Schwartz, MD Received July 2, 2015, ORIGINAL RESEARCHObjectives-Previous studies have demonstrated an association between adverse obstetric outcomes, such as preterm birth, and in utero inflammation. The fetal thymus, which can be visualized in the anterior mediastinum on obstetric sonography, may involute in response to such inflammation and thus may identify pregnancies at increased risk for these outcomes. We therefore sought to determine whether secondtrimester fetal thymus measurements are associated with preterm birth.Methods-Transabdominal fetal thymus measurements were prospectively obtained in singleton pregnancies at gestational ages of 18 weeks to 23 weeks 6 days during a 5-month period. The transverse and anterorposterior thymus diameters and the thymicthoracic ratio were measured. Delivery outcomes were collected from our clinical database. The primary outcome was preterm birth, which we defined as delivery between 24 weeks and 36 weeks 6 days. Small for gestational age (SGA) and pregnancyrelated hypertension, which are adverse obstetric outcomes that may also be associated with in utero inflammation, were included as secondary outcomes.Results-We included 520 patients with thymus measurements and obstetric outcome data. The prevalence of preterm birth was 12.3% (n = 64). None of the thymus measurements were associated with preterm birth. Similarly, there was no association between thymus measurements and SGA or pregnancy-related hypertension.Conclusions-Sonographic assessment of the second-trimester fetal thymus did not identify patients at increased risk for preterm birth, SGA, and pregnancy-related hypertension. Routine thymus measurements during the second-trimester anatomic scan are not clinically useful for prediction of preterm birth and other adverse outcomes.

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Section: Methodsmentioning

confidence: 99%

Second‐Trimester Sonographic Thymus Measurements Are Not Associated With Preterm Birth and Other Adverse Obstetric Outcomes

Brandt

Bastek

Wang

et al. 2016

J of Ultrasound Medicine

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“…Likewise, infants with very low birth weight with funisitis had signifi cantly lower sRAGE values in cord blood compared to the healthy infants (9). Bastek and colleagues found signifi cantly lower cord blood sRAGE in infants with early-onset sepsis (10). The levels of sRAGE were signifi cantly decreased in foetuses and neonates with a mounting infl ammatory reaction.…”

Section: Discussionmentioning

confidence: 96%

Soluble receptor for advanced glycation end products in late-onset neonatal infection

Zolakova¹,

Zolak²,

Hatok³

et al. 2016

BLL

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OBJECTIVES: To assess the plasma levels of sRAGE (soluble receptor for advanced glycation end products) in infected and non-infected preterm neonates and to compare their diagnostic values with standard infection biomarkers. BACKGROUND: RAGE activates pathways responsible for acute and chronic infl ammation. The soluble type of this receptor, sRAGE, which acts as a decoy receptor, has been linked to the severity of sepsis and its outcome. METHODS: Prospective clinical study was carried out from January 2011 to August 2013. There were 33 neonates included according to their infection status and divided into subgroups as follows: infected (I), septic (S), non-infected controls (C). RESULTS: We found signifi cantly lower values of sRAGE in the subgroup S (905.54±220.53 pg/mL; p < 0.028), while borderline values were higher in the subgroup I vs C (2158.33±197.33 pg/mL vs 1744.80±157.74 pg/mL; p < 0.064). By analysing the interobserver concordance we detected 70 % agreement as to sRAGE values detected in neonatal late-onset infections and sepsis, while procalcitonin was used as golden standard. CONCLUSION: Plasma sRAGE values refl ect the severity of the infl ammatory status in late-onset infection and sepsis in preterm neonates. Our results indicate that sRAGE could be a good potential biomarker of late-onset neonatal infection and sepsis (Tab. 2, Ref. 14). Text in PDF www.elis.sk. KEY WORDS: sRAGE, biomarker, preterm neonate, late-onset infection, late-onset sepsis. Acknowledgement: This work was supported by project "Support of human resources development using the most modern methods and forms of education on JFM CU in Martin" co-fi nanced by EU sources and European Social Fund. We thank all the research staff of Department of Neonatology JFM CU and UH Martin who worked on recruitment and sample collection, as well as staff at the Department of Clinical Biochemistry UHM, and participating families. This work was supported by project "Support of human resources development using the most modern methods and forms of education on JFM CU in Martin" co-fi nanced by EU sources and European Social Fund.

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“…Negative RAGE isoforms can inhibit endogenous inflammation and their protective function has been confirmed in diabetes mellitus, some cardiovascular diseases, atherosclerosis, and in some types of neoplasms [ 56 – 62 ]. Only a few studies have assessed the importance of RAGE for preterm labor [ 39 – 42 , 63 ]. These studies did not clearly prove a protective function of negative soluble RAGE isoforms in such complications of pregnancy.…”

Section: Discussionmentioning

confidence: 99%

“…The hypothesis of the protective role of RAGE negative variants and its ligands leads to the question of whether soluble RAGE levels in pregnancy can affect the prevalence of premature labor associated with spontaneous uterine contractility and preterm rupture of the membranes. Only a few authors have investigated RAGE in premature labor [ 36 – 42 ].…”

Section: Introductionmentioning

confidence: 99%

Soluble receptors for advanced glycation end products and receptor activator of NF-κB ligand serum levels as markers of premature labor

Rzepka

Dołęgowska

Sałata

et al. 2015

BMC Pregnancy Childbirth

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BackgroundThis study aimed to determine the relationships between secretory and endogenous secretory receptors for advanced glycation end products (sRAGE, esRAGE), sRANKL, osteoprotegerin and the interval from diagnosis of threatened premature labor or premature rupture of the fetal membranes to delivery, and to evaluate the prognostic values of the assessed parameters for preterm birth.MethodsNinety women between 22 and 36 weeks’ gestation were included and divided into two groups: group A comprised 41 women at 22 to 36 weeks’ gestation who were suffering from threatened premature labor; and group B comprised 49 women at 22 to 36 weeks’ gestation with preterm premature rupture of the membranes. Levels of sRAGE, esRAGE, sRANKL, and osteoprotegerin were measured. The Mann–Whitney test was used to assess differences in parameters between the groups. For statistical analysis of relationships, correlation coefficients were estimated using Spearman’s test. Receiver operating characteristics were used to determine the cut-off point and predictive values.ResultsIn group A, sRAGE and sRANKL levels were correlated with the latent time from symptoms until delivery (r = 0.422; r = −0.341, respectively). The sensitivities of sRANKL and sRAGE levels for predicting preterm delivery were 0.895 and 0.929 with a negative predictive value (NPV) of 0.857 and 0.929, respectively. In group B, sRAGE and sRANKL levels were correlated with the latent time from pPROM until delivery (r = 0.381; r = −0.439). The sensitivity of sRANKL and sRAGE for predicting delivery within 24 h after pPROM was 0.682 and 0.318, with NPVs of 0.741 and 0.625, respectively. Levels of esRAGE and sRANKL were lower in group A than in group B (median = 490.2 vs 541.1 pg/mL; median = 6425.0 vs 11362.5 pg/mL, respectively).ConclusionsCorrelations between sRAGE, sRANKL, and pregnancy duration after the onset of symptoms suggest their role in preterm delivery. The high prognostic values of these biomarkers indicate their usefulness in diagnosis of pregnancies with threatened premature labor.

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The soluble receptor for advanced glycation end products can prospectively identify patients at greatest risk for preterm birth

Abstract: The sRAGE can be used to help predict adverse perinatal outcomes. Patients with higher levels of sRAGE - who therefore may have an enhanced capability to regulate their immune response - appear less likely to experience PTB and neonatal sepsis.

Cited by 17 publications

References 48 publications

Second‐Trimester Sonographic Thymus Measurements Are Not Associated With Preterm Birth and Other Adverse Obstetric Outcomes

Second‐Trimester Sonographic Thymus Measurements Are Not Associated With Preterm Birth and Other Adverse Obstetric Outcomes

Soluble receptor for advanced glycation end products in late-onset neonatal infection

Soluble receptors for advanced glycation end products and receptor activator of NF-κB ligand serum levels as markers of premature labor

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