Pediatric Critical Care Unit, Hospital Infantil Universitario Niño Jesús, Avenida Menéndez Pelayo 65, Madrid, Spain,
Lung. 2015 Feb;193(1):19-23. doi: 10.1007/s00408-014-9663-9. Epub 2014 Oct 30.
Traditional inflammatory biomarkers are insufficient for the evaluation of bronchiolitis severity. Recent investigations have shown that the receptor for advanced glycation end product (RAGE) and its soluble isoforms (sRAGE) play a critical role in the pathogenesis of lung injury. Main objective was to assess the serum levels of sRAGE of children with severe bronchiolitis admitted to the pediatric intensive care unit (PICU). Secondary objective was to study sRAGE correlation with the evolution and traditional biomarkers.
Prospective, observational and descriptive study, 43 healthy controls and 37 patients (December 2011-February 2012) were enrolled. sRAGE levels were assessed and compared. In patients, the relation between sRAGE levels and clinical evolution, respiratory assistance, white blood cell count, absolute neutrophils count, serum C-reactive protein, and serum procalcitonin was analyzed.
A statistical difference was found in the mean value of sRAGE at PICU admission between patients and controls (1,215.7 ± 535 vs 849 ± 579 pg/ml). Also a significant inverse correlation was found between sRAGE and the Wood-Downes Score at admission (p = 0.02).
Serum sRAGE could be elevated in children with bronchiolitis. Larger clinical studies are necessary to elucidate its role as a bronchiolitis inflammatory and/or lung injury biomarker.
传统的炎症生物标志物不足以评估细支气管炎的严重程度。最近的研究表明，晚期糖基化终产物受体（RAGE）及其可溶性异构体（sRAGE）在肺损伤的发病机制中起着关键作用。主要目的是评估重症毛细支气管炎患儿血清 sRAGE 水平，并入住儿科重症监护病房（PICU）。次要目的是研究 sRAGE 与演变和传统生物标志物的相关性。
前瞻性、观察性和描述性研究，纳入 43 名健康对照者和 37 名患者（2011 年 12 月至 2012 年 2 月）。评估并比较 sRAGE 水平。在患者中，分析 sRAGE 水平与临床演变、呼吸辅助、白细胞计数、绝对中性粒细胞计数、血清 C 反应蛋白和血清降钙素原之间的关系。
患者和对照组在 PICU 入院时 sRAGE 的平均值存在统计学差异（1,215.7 ± 535 与 849 ± 579 pg/ml）。此外，sRAGE 与入院时 Wood-Downes 评分之间存在显著的负相关（p = 0.02）。
毛细支气管炎患儿血清 sRAGE 可能升高。需要更大的临床研究来阐明其作为毛细支气管炎炎症和/或肺损伤生物标志物的作用。
