sRAGE is elevated in septic patients and associated with patients outcome

Background. (1) To evaluate in septic patients the plasma levels of soluble receptor for advanced glycation end products (sRAGE), a soluble splice variant of the full length receptor RAGE, which is involved in acute inflammation (2) to determine whether sRAGE could be used as a potential diagnostic and prognostic marker in sepsis in the surgical intensive care unit. Materials and methods. An observational clinical noninterventional pilot study in a surgical intensive care unit with patients admitted to the intensive care unit over a 6-mo period with clinical evidence of severe sepsis or septic shock. Results. Twenty-nine intensive care patients were enrolled in the study within the first 24 h after onset of severe sepsis or septic shock. Eight healthy volunteers served as controls. Plasma sRAGE concentrations were elevated in septic patients compared with healthy volunteers (1764 +/- 138 versus 1026 +/- 177 pg/mL, P < 0.05). Additionally, nonsurvivors after 28 days have had higher plasma sRAGE concentrations than survivors (2302 +/- 189 versus 1326 +/- 112 pg/mL, P < 0.001). Receiver operating characteristic curve analysis of plasma sRAGE concentrations of septic patients showed a specificity of 75% and a sensitivity of 84.6% with 1596 pg/mL as cutoff. Conclusions. This is the first study showing elevated plasma sRAGE concentrations in septic patients. It is noteworthy that nonsurvivors had higher plasma sRAGE concentrations than survivors, suggesting that sRAGE is related to severity and outcome of septic patients. Further clinical studies are required to investigate the usefulness of sRAGE as a new sepsis marker. (C) 2008 Elsevier Inc. All rights reserved.