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Serum Soluble Receptor for Advanced Glycation End Products in Infants With Bronchiolitis: Associations With Acute

Jason T Patregnani1,2,3,4, Michimasa Fujiogi5, Carlos A Camargo5

  • 1Division of Cardiac Critical Care Medicine, Children's National Hospital, Washington, DC, USA.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|November 11, 2020
PubMed

Insights

Higher serum soluble receptor for advanced glycation end products (sRAGE) levels in infants hospitalized for bronchiolitis were linked to reduced acute and chronic morbidities, including recurrent wheeze. This suggests sRAGE may play a protective role independent of illness severity.

Area of Science:

  • Pediatric respiratory diseases
  • Biomarkers in critical care
  • Inflammatory pathways in infant lung disease

Background:

  • Bronchiolitis causes significant acute and chronic illness in young children.
  • The underlying pathobiology of bronchiolitis and its long-term effects remain unclear.
  • Investigating biomarkers like soluble receptor for advanced glycation end products (sRAGE) is crucial for understanding disease mechanisms.

Purpose of the Study:

  • To examine the association between serum sRAGE levels and acute/chronic morbidities in infants hospitalized with bronchiolitis.
  • To determine if sRAGE levels predict intensive care unit (ICU) admission or recurrent wheeze by age 3.
  • To explore the direct and indirect effects of sRAGE on the development of recurrent wheeze.

Main Methods:

  • A multicenter, multiyear cohort study of 886 infants hospitalized for bronchiolitis.
  • Serum sRAGE levels were measured at hospitalization.
  • Associations with intensive care use and recurrent wheeze were analyzed using multivariable and mediation models.

Main Results:

  • Higher presenting serum sRAGE levels were associated with a lower risk of intensive care use (OR, 0.39; P = .03).
  • Elevated sRAGE levels significantly reduced the rate of recurrent wheeze by age 3 (HR, 0.58; P = .03).
  • Mediation analysis indicated a significant direct effect of sRAGE on recurrent wheeze, but not an indirect effect via acute severity.

Conclusions:

  • Serum sRAGE levels are inversely associated with both acute and chronic morbidities following bronchiolitis.
  • The protective effect of sRAGE on recurrent wheeze development appears to operate through pathways distinct from acute bronchiolitis severity.
  • sRAGE may serve as a potential biomarker for predicting long-term outcomes in pediatric bronchiolitis.
Abstract

Keywords:
advancedasthmabronchiolitiscohortglycation end productsmediationpediatrics

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