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sRAGE as severe acute bronchiolitis biomarker, prospective observational study
Montserrat Sierra-Colomina1, Alberto García-Salido2, Inés Leoz-Gordillo2
1Department of Pediatric Critical Care, Queen Fabiola Children's University Hospital, Bruxelles, Belgium.
Insights
Serum soluble receptor for advanced glycation end products (sRAGE) levels did not predict acute bronchiolitis (AB) severity in infants. However, sRAGE was higher in patients with lung consolidation and correlated with inflammatory markers.
Area of Science:
- Pediatric critical care medicine
- Respiratory medicine
- Immunology
Background:
- Acute bronchiolitis (AB) is a common cause of infant hospitalization, with some cases requiring intensive care.
- Identifying infants at high risk for severe AB progression is crucial for timely intervention.
- The soluble receptor for advanced glycation end products (sRAGE) is implicated in immune responses and inflammation.
Purpose of the Study:
- To investigate serum sRAGE levels in infants with severe AB.
- To assess the correlation between serum sRAGE and AB severity, complications, and outcomes.
- To explore the potential role of sRAGE as a biomarker for severe AB.
Main Methods:
- A prospective, observational study involving 52 infants with severe AB admitted to a Pediatric Intensive Care Unit (PICU).
- Serum sRAGE levels were measured and compared to 27 healthy controls.
- Correlations were analyzed with clinical severity scores, causative viruses, respiratory support, and length of stay.
Main Results:
- Serum sRAGE levels were not significantly different between severe AB patients and controls.
- No correlation was found between sRAGE and AB severity, causative viruses, or clinical outcomes.
- Serum sRAGE was higher in patients with lung consolidation and showed a weak positive correlation with C-reactive protein and procalcitonin.
Conclusions:
- Serum sRAGE is not a reliable predictor of AB severity or prognosis in hospitalized infants.
- Elevated sRAGE in the presence of lung consolidation warrants further investigation into the AGE-RAGE axis in AB.
- Additional research is needed to fully elucidate the role of sRAGE in pediatric respiratory infections.
Introduction And Objectives:
Acute bronchiolitis (AB) is the leading cause of hospitalization in infants and around 5% require intensive care treatment. Early identification of children diagnosed with AB at a high risk of severe progression is of great interest. The receptor for advanced glycation end products (RAGE), highly expressed in lung tissue, regulates immune responses and inflammation, and its soluble form, sRAGE, is believed to have an anti-inflammatory role. We hypothesized serum sRAGE might be a major determinant of AB severity and prognosis. This study was conducted to measure serum sRAGE in infants with severe AB and to assess its correlation with clinical severity, immediate complications, and outcome.
Methods:
Single-center, prospective, observational study of hospitalized children with severe bronchiolitis admitted to the Pediatric Intensive Care Unit (PICU), from September 2015 to September 2016.
Results:
A total of 52 children and 27 controls were included. The cases age ranged from 11 days to 21 months, resulting in a significant age difference with controls (11.85 vs 4.84 months, P < .01). Serum levels of sRAGE were lower but not significant in severe AB patients than in controls (1350.93 vs 1450.42 pg/mL; P = .399). No correlation was found between serum sRAGE and causative viruses, clinical symptoms, Wood-Downes score (a clinical severity score) on admission, respiratory support, or length of hospital stay. Serum sRAGE was also lower in the cases having had a previous respiratory disease (1463.84 vs 1072.43 pg/mL; P = .049). However, it was higher in patients with any lung consolidation on the chest X-ray (1584.79 vs 1131.62 pg/mL; P = .044) and weakly positively correlated with classical biomarkers (maximum C-reactive protein, +0.295, P = .034; maximum procalcitonin, +0.309; P = .029).
Conclusion:
This single-center study reveals that sRAGE couldn't predict AB severity or outcome in children hospitalized at PICU. Nevertheless, it significantly increased in the presence of any lung consolidation and had a positive correlation with classical biomarkers. The utility of sRAGE in this population could be probably elucidated with a better understanding of AGE-RAGE axis.
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