Soluble RAGE as a severity marker in community acquired pneumonia associated sepsis

BMC Infectious Diseases

Research Article

Rodrigo M Narvaez-Rivera¹  Adrian Rendon²  Mario C Salinas-Carmona³  Adrian G Rosas-Taraco³ 

[1] Department of Internal Medicine. Monterrey Nuevo Leon, Universidad Autonoma de Nuevo Leon, UANL, School of Medicine and University Hospital, Mexico;School of Medicine and University Hospital, CIPTIR (Centro de Investigacion, Prevencion y Tratamiento de Infecciones Respiratorias). Monterrey, Universidad Autonoma de Nuevo Leon, UANL, Nuevo Leon, Mexico;School of Medicine and University Hospital, Department of Immunology. Monterrey Nuevo Leon, Universidad Autonoma de Nuevo Leon, UANL, Mexico;

关键词: SOFA score;    Soluble RAGE;    Severity markers;    Community-acquired pneumonia;    Survival;   

DOI  :  10.1186/1471-2334-12-15

 received in 2011-02-03, accepted in 2012-01-20,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundCommunity-acquired pneumonia (CAP) is considered the most important cause of death from infectious disease in developed countries. Severity assessment scores partially address the difficulties in identifying high-risk patients. A lack of specific and valid pathophysiologic severity markers affect early and effective sepsis therapy. HMGB-1, sRAGE and RAGE have been involved in sepsis and their potential as severity markers has been proposed. The aim of this study was to evaluate HMGB-1, RAGE and sRAGE levels in patients with CAP-associated sepsis and determine their possible association with clinical outcome.MethodWe evaluated 33 patients with CAP-associated sepsis admitted to the emergency room and followed in the medical wards. Severity assessment scores (CURB-65, PSI, APACHE II, SOFA) and serologic markers (HMGB-1, RAGE, sRAGE) were evaluated on admission.ResultsThirty patients with a diagnosis of CAP-associated sepsis were enrolled in the study within 24 hours after admission. Fourteen (46.6%) had pandemic (H1N1) influenza A virus, 2 (6.6%) had seasonal influenza A and 14 other diagnoses. Of the patients in the study group, 16 (53.3%) had a fatal outcome. ARDS was observed in 17 (56.6%) and a total of 22 patients had severe sepsis on admission (73%). The SOFA score showed the greatest difference between surviving and non-surviving groups (P = .003) with similar results in ARDS patients (P = .005). sRAGE levels tended to be higher in non-surviving (P = .058) and ARDS patients (P = .058). Logistic regression modeling demonstrated that SOFA (P = .013) and sRAGE (P = .05) were the only variables that modified the probability of a fatal outcome.ConclusionThe association of elevated sRAGE with a fatal outcome suggests that it may have an independent causal effect in CAP. SOFA scores were the only clinical factor with the ability to identify surviving and ARDS patients.

【 授权许可】

Unknown   
© Narvaez-Rivera et al; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.