Abstract
BackgroundThe soluble receptor for advanced glycation end-products (sRAGE) has been suggested that it acts as a decoy for capturing advanced glycation end-products (AGEs) and inhibits the activation of the oxidative stress and apoptotic pathways. Lung AGEs/sRAGE is increased in idiopathic pulmonary fibrosis (IPF). The objective of the study was to evaluate the AGEs and sRAGE levels in serum as a potential biomarker in IPF.MethodsSerum samples were collected from adult patients: 62 IPF, 22 chronic hypersensitivity pneumonitis (cHP), 20 fibrotic non-specific interstitial pneumonia (fNSIP); and 12 healthy controls. In addition, 23 IPF patients were re-evaluated after 3-year follow-up period. Epidemiological and clinical features were recorded: age, sex, smoking habits, and lung function. AGEs and sRAGE were evaluated by ELISA, and the results were correlated with pulmonary functional test values.ResultsIPF and cHP groups presented a significant increase of AGE/sRAGE serum concentration compared with fNSIP patients. Moreover, an inverse correlation between AGEs and sRAGE levels were found in IPF, and serum sRAGE at diagnosis correlated with FVC and DLCO values. Additionally, changes in serum AGEs and sRAGE correlated with % change of FVC, DLCO and TLC during the follow-up. sRAGE levels below 428.25 pg/ml evolved poor survival rates.ConclusionsThese findings demonstrate that the increase of AGE/sRAGE ratio is higher in IPF, although the levels were close to cHP. AGE/sRAGE increase correlates with respiratory functional progression. Furthermore, the concentration of sRAGE in blood stream at diagnosis and follow-up could be considered as a potential prognostic biomarker.
Highlights
The soluble receptor for advanced glycation end-products has been suggested that it acts as a decoy for capturing advanced glycation end-products (AGEs) and inhibits the activation of the oxidative stress and apoptotic pathways
AGEs and soluble receptor for advanced glycation end-products (sRAGE) serum concentration in pulmonary fibrosis AGEs levels were significantly higher in serum samples from idiopathic pulmonary fibrosis (IPF) and chronic hypersensitivity pneumonitis (cHP) compared with control and fibrotic nonspecific interstitial pneumonia (fNSIP) patients (p < 0.01)
The present results suggest that serum AGEs and sRAGE are different in IPF than in fNSIP, and their ratio is even higher than in cHP, which could be a useful information for the differential diagnosis of these fibrotic interstitial lung diseases (ILDs)
Summary
The soluble receptor for advanced glycation end-products (sRAGE) has been suggested that it acts as a decoy for capturing advanced glycation end-products (AGEs) and inhibits the activation of the oxidative stress and apoptotic pathways. Lung AGEs/sRAGE is increased in idiopathic pulmonary fibrosis (IPF). The objective of the study was to evaluate the AGEs and sRAGE levels in serum as a potential biomarker in IPF. Idiopathic pulmonary fibrosis (IPF) is the most frequent form of fibrotic interstitial lung diseases (ILDs), which presents a variable outcome and is generally fatal within 2–4 years from diagnosis [1]. Some fibrosing lung entities such as chronic hypersensitivity pneumonitis (cHP) and fibrotic nonspecific interstitial pneumonia (fNSIP) represent a challenge in the differential diagnosis for IPF as there are clinical and radiological similarities [4,5,6,7,8]. Even after an invasive procedure such as lung biopsy, it occasionally remains difficult to differentiate IPF from cHP [9, 10]. Serum and broncoalveolar biological markers have been
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