Relationship between the Levels of Calprotectin and Soluble Receptor for Advanced Glycation End Products with Abdominal Aortic Aneurysm Diameter: A Preliminary Clinical Trial

Abstract

An abdominal aortic aneurysm (AAA) is a dilatation of the abdominal aorta greater than 50% of the diameter of a healthy aorta. Previous experimental studies confirm the effect of calprotectin (CAL) on the onset of arterial pathology. It has been suggested that low levels of soluble receptors for advanced glycation end products (RAGEs) increase levels of cytokines that lead to the inhibition of matrix metalloproteinases (MMPs), affecting AAA formation. This study aimed to analyze the correlation of levels of RAGE and CAL with AAA diameter. A group of 32 patients aged 50–75 with diagnosed AAA was enrolled in the study. This group of patients was further divided into three subgroups based on AAA diameter: (1) <4.5 cm, (2) 4.5–5.5 cm, (3) >5.5 cm. Peripheral blood was drawn from all participants on admission to measure the serum CAL and RAGE levels. An enumeration survey was performed three months after AAA surgical treatment. CAL and RAGE plasma levels were measured with the enzyme-linked immunosorbent assay (ELISA). The median CAL levels were 2273.0 ng/mL before and 1217.0 ng/mL after treatment. There was a statistically significant decrease in CAL levels following the surgical treatment (p = 0.003). The correlation analysis between CAL levels and RAGE levels before and after surgical treatment showed no statistically significant correlations. In addition, there were no statistically significant correlations between CAL and RAGE levels with AAA size. In conclusion, CAL levels appear to be a significant marker in patients with AAA. There is an almost twofold decrease in CAL levels after AAA excision.

Calprotectin as a new inflammatory marker of abdominal aortic aneurysm: A pilot study

“…15 They also found differences in the levels of soluble receptor for advanced glycation end products (RAGE) between the two groups, 16 but were unable to establish a correlation between both markers (calprotectin or RAGE) and aortic diameter, probably due to limited sample size. 17 Liu et al 18 also showed increased levels of calprotectin in AAA serum samples. Our results corroborate those of Hauzer et al and Liu et al, and all together appear to highlight the role of calprotectin as a feasible AAA biomarker.…”

“…15 They also found differences in the levels of soluble receptor for advanced glycation end products (RAGE) between the two groups, 16 but were unable to establish a correlation between both markers (calprotectin or RAGE) and aortic diameter, probably due to limited sample size. 17 In contrast, our control group comprised healthy volunteers and carotid endarterectomy patients with severe atherosclerosis, who were analyzed separately to determine whether calprotectin would be able to differentiate AAA from other vascular diseases. Interestingly, calprotectin levels were higher in patients with AAA than in the HV and CE groups, whereas HV and CE showed similar calprotectin levels, highlighting its specificity as an AAA biomarker in cardiovascular context.…”

A population-based study on hyperinsulinaemia and arterial stiffness in men with and without abdominal aortic aneurysm

“…Concentrations of the cross-linking AGE pentosidine have been negatively correlated with aortic diameter [ 40 ], suggesting a protective effect against aortic dilatation. On the other hand, increased SAF of AGE has been reported in patients with AAA compared with controls independently of the presence of concomitant atherosclerosis [ 41 ], and levels of the soluble receptor for AGE have been correlated to AAA size [ 42 ]. Blocking of this receptor has even been evaluated in animal models and proposed as a potential future treatment of AAA [ 43 ].…”

Pathogenesis of abdominal aortic aneurysms from the vascular surgeon perspective – knowledge summary

“…Patients with AAA also display an increased level of calprotectin in comparison to patients with a healthy aorta. That level decreases significantly after the removal of AAA [11,12].…”