Increased levels of soluble receptor for advanced glycation end products (sRAGE) and high mobility group box 1 (HMGB1) are associated with death in patients with acute respiratory distress syndrome.

OBJECTIVES: Receptor for advanced glycation end products (RAGE) plays a role in inflammatory reactions. Soluble RAGE (sRAGE) level is elevated in patients with acute respiratory distress syndrome (ARDS). However, which clinical parameters and inflammatory biomarkers including sRAGE are associated with death in ARDS patients remain unknown.

DESIGN AND METHODS: We examined whether sRAGE level was independently associated with death in 20 ARDS patients with severe infection.

RESULTS: Compared with age- and sex-matched control subjects, blood pressure levels were lower and KL-6, high mobility group box 1 (HMGB1), interleukin-6 and sRAGE levels were higher in ARDS patients. In multivariate analysis, sRAGE was associated with death in ARDS patients, but severity of illness was not. HMGB1 was a sole independent correlate of sRAGE.

CONCLUSIONS: This study demonstrated that sRAGE was independently associated with death in ARDS patients. Our present results suggest active involvement of HMGB1-RAGE axis in poor prognosis of ARDS.