Plasma sRAGE and N-(carboxymethyl) lysine in patients with CHF and/or COPD
Article first published online: 17 APR 2013
© 2013 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd
European Journal of Clinical Investigation
Volume 43, Issue 6, pages 562–569, June 2013
How to Cite
Eur J Clin Invest 2013
- Issue published online: 13 MAY 2013
- Article first published online: 17 APR 2013
- Accepted manuscript online: 2 APR 2013 01:00AM EST
- Manuscript Accepted: 4 MAR 2013
- Manuscript Received: 5 NOV 2012
- Italian Ministry of Health
- Consorzio Ferrara Ricerche
- Advanced glycation end products;
- chronic heart failure;
- chronic obstructive pulmonary disease;
- N-terminal pro-brain natriuretic peptide;
- soluble receptor for advanced glycation end products
Knowledge of the role of the receptor for advanced glycation end products (RAGE), particularly its soluble form (sRAGE), and of its advanced glycation end product (AGE) ligand, N-(carboxymethyl)lysine adducts (CML), is limited in chronic heart failure (CHF) and in chronic obstructive pulmonary disease (COPD). We evaluated whether the AGE/RAGE system is activated in stable CHF and COPD, and whether plasma sRAGE and CML levels are affected by clinical and functional parameters.
Materials and methods
We measured plasma levels of sRAGE and CML using a sandwich enzyme-linked immunosorbent assay (ELISA) in 143 subjects, aged ≥ 65 years, divided into five groups: 58 with CHF, 23 with COPD, 27 with CHF+COPD and 35 controls (17 healthy smokers and 18 healthy nonsmokers). Individuals with diabetes were excluded from the study.
Plasma levels of sRAGE and CML were higher in CHF patients than in controls [sRAGE: 0·48 (0·37–0·83) vs. 0·42 (0·29–0·52) ng/mL, P = 0·01; CML: 1·95 (1·58–2·38) vs. 1·68 (1·43–2·00) ng/mL, P = 0·01]. By contrast, sRAGE and CML were not different between both COPD and CHF+COPD patients and controls (P > 0·05). N-terminal pro-brain natriuretic peptide (Nt-pro BNP) correlated with sRAGE, but not with CML, in the patient groups: CHF (r = 0·43, P < 0·001), COPD (r = 0·77, P < 0·0001) and CHF/COPD (r = 0·43, P = 0·003).
Plasma levels of sRAGE and CML are increased in CHF, but not in COPD patients. The robust association between NT-pro BNP, a diagnostic and prognostic marker in CHF, and sRAGE concentrations might suggest a possible BNP pathway of amplification of inflammation via the AGE/RAGE system.