Surfactant protein B and RAGE increases in the plasma during cardiopulmonary bypass: a pilot study

Agostoni, Piergiuseppe; Banfi, Cristina; Brioschi, Maura; Magrì, Damiano; Sciomer, Susanna; Berna, Giovanni; Brambillasca, Claudio; Marenzi, Giancarlo; Sisillo, Erminio

doi:10.1183/09031936.00045910

Cited by 31 publications

(39 citation statements)

References 45 publications

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“…However, the patient group in this study by Liu and colleagues was dissimilar to ours; not least, because a number of children in their study developed ALI, whereas no adult in our study group did. For this reason, we chose not to measure markers of lung injury such as surfactant derived proteins, in addition to sRAGE, as others have done previously [23]. The study by Liu and colleagues also showed that sRAGE levels in children doubled 1 h after snCPB; which is a similar fold increase to that reported in a pilot study in aduts undergoing snCPB [23] and also in our current study.…”

Section: Discussionsupporting

confidence: 82%

“…For this reason, we chose not to measure markers of lung injury such as surfactant derived proteins, in addition to sRAGE, as others have done previously [23]. The study by Liu and colleagues also showed that sRAGE levels in children doubled 1 h after snCPB; which is a similar fold increase to that reported in a pilot study in aduts undergoing snCPB [23] and also in our current study. Whilst associations with outcome were not reported in the previous study in adults [23], plasma sRAGE levels in children, immediately postoperatively, were shown to be an independent predictor of postop ALI [22].…”

Section: Discussionsupporting

confidence: 82%

“…In patients with sepsis [19] and pneumonia [20], the highest levels were detected in nonsurvivors; and in trauma victims, levels were correlated with the development of acute renal failure [21]. In children undergoing cardiac surgery, sRAGE levels increased and correlated with outcome [22], and in adults, levels were raised postoperatively, but associations with outcome were not reported [23]. However, whether raised levels of sRAGE prior to a second inflammatory insult such as snCPB result in poorer outcome has not been investigated.…”

Section: Introductionmentioning

confidence: 99%

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Association between Preoperative Plasma sRAGE Levels and Recovery from Cardiac Surgery

Creagh-Brown

Quinlan

Hector

et al. 2013

Mediators of Inflammation

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Background. The receptor for advanced glycation end products (RAGE) is an inflammation-perpetuating receptor, and soluble RAGE (sRAGE) is a marker of cellular RAGE expression. This study investigated whether raised plasma levels prior to surgery of sRAGE or S100A8/A9 (a RAGE ligand) were associated with longer duration of hospital care in patients undergoing cardiac surgery necessitating cardiopulmonary bypass. Methods. Patients (n = 130) undergoing elective cardiac surgery were enrolled prospectively. Plasma sRAGE and S100A8/A9 concentrations were measured before and 2 h after surgery. Results. Preoperative plasma sRAGE increased significantly (P < 0.0001) from 1.06 ng/mL (IQR, 0.72–1.76) to 1.93 ng/mL (IQR, 1.14–2.63) 2 h postoperatively. Plasma S100A8/9 was also significantly (P < 0.0001) higher 2 h postoperatively (2.37 μg/mL, IQR, 1.81–3.05) compared to pre-operative levels (0.41 μg/mL, IQR, 0.2–0.65). Preoperative sRAGE, but not S100A8/A9, was positively and significantly correlated with duration of critical illness (r = 0.3, P = 0.0007) and length of hospital stay (LOS; r = 0.31, P < 0.0005). Multivariate binary logistic regression showed preoperative sRAGE to be, statistically, an independent predictor of greater than median duration of critical illness (odds ratio 16.6, P = 0.014) and to be, statistically, the strongest independent predictor of hospital LOS. Conclusion. Higher preoperative plasma sRAGE levels were associated with prolonged duration of care in adults undergoing cardiac surgery requiring cardiopulmonary bypass.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Association between Preoperative Plasma sRAGE Levels and Recovery from Cardiac Surgery

Creagh-Brown

Quinlan

Hector

et al. 2013

Mediators of Inflammation

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“…For the systemic inflammatory response was proposed to play a pivotal role in the pathogenesis of CPB-induced acute lung injury [27,28], various of factors concerned inflammation, not only the changes in the levels, but also the time courses or the patterns of release, had been described for the affecting the incidence, severity and clinical outcome of the CPB-ALI such as IL-6, IL-8, TNF-α and endotoxins et al Recent studies highlighting the novel early biomarks of CPB-ALI were performed, such as surfactant derived protein B (SPB) and plasma receptor for advanced glycation end products (RAGE), and have shown to be a promising diagnostic method in both adult and pediatric population [29,30]. Though, the change of pGSN in acute lung injury was still controversial for the differences of etiologies, study kinetic and damage severity.…”

Section: Discussionmentioning

confidence: 99%

The role of plasma gelsolin in cardiopulmonary bypass induced acute lung injury in infants and young children: a pilot study

et al. 2014

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BackgroundAcute lung injury (ALI) induced by cardiopulmonary bypass (CPB, CPB-ALI) is a common and serious complication after cardiac surgery. And infants and young children are more prone to CPB-ALI. The purpose of this study was to investigate the perioperative changes of plasma gelsolin (pGSN) in patients below 3years of age with cardiac surgeries and CPB, and determine whether pGSN are associated with the occurrence and severity of CPB-ALI.MethodsSeventy-seven consecutive patients ≤3 years of age with congenital heart diseases (CHD) performed on open heart surgery with CPB were finally enrolled, and assigned to ALI and non-ALI groups according to the American-European Consensus Criteria. Plasma concentrations of gelsolin and total protein were measured at following 8 time points: before CPB (a), after CPB (b), 2 hours after CPB (c), 6 hours after CPB (d), 12 hours after CPB (e), 24 hours after CPB (f), 48 hours after CPB (g) and 72 hours after CPB (h).ResultsTwenty-seven (35.1%) patients developed CPB-ALI in the study, including eleven (14.3%) patients with ARDS. The earliest significant drop of pGSN and normalized pGSN (pGSNN) of ALI group both occurred at 6 hours after CPB (p = 0.04 and p < 0.01), which was much earlier than those of non-ALI group (48 hours, p = 0.03 and 24 hours, p < 0.01); PGSN of ALI group before CPB and 6 hours after CPB were both significantly lower than those of non-ALI group (p < 0.01); PGSNN of ALI group before CPB and 6 hours after CPB were both significantly lower than those of non-ALI group (p < 0.01, p = 0.04); PGSN before CPB was the only independent risk factor predicting the occurrence of CPB-ALI (OR, 1.023; 95% CI, 1.007-1.039; p < 0.01) with an AUC of 0.753 (95% CI, 0.626-0.880); The optimal cutoff value of pGSN before CPB was 264.2 mg/L, with a sensitivity of 58.3% and a specificity 94.7%. And lower pGSN before CPB was significantly associated with the severity of CS-AKI (r = −0.45, p < 0.01).ConclusionsPatients developing CPB-ALI had lower plasma gelsolin reservoir and a much more amount and rapid consumption of plasma gelsolin early after operation. PGSN before CPB was an early and sensitive predictor of CPB-ALI in infants and young children undergoing cardiac surgery, and was negatively correlated with the severity of CPB-ALI.

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“…Proteolytic processing of the SP-B precursor into mature protein takes place intra- and extracellularly [16], resulting in the occurrence of the mature protein as well as the SP-B precursor and the processing intermediates in the alveolar epithelial lining fluid [17]. Because of differences in hydrophobici ty, mature SP-B is intimately associated with the phospholipid-rich surfactant [18], whereas the less hydrophobic SP-B precursor and its processing intermediates (C-proSP-B and proSP-B) are less tightly bound to phospholipids and can therefore predominantly be recovered in the hydrophilic parts of, e.g., bronchoalveolar lavage fluid supernatant [17]. In addition, Agostoni et al [19] stated that the immature form of SP-B seems to remain high in the blood for a longer time in patients with acute lung injury compared with mature SP-B.…”

Section: Introductionmentioning

confidence: 99%

C-proSP-B: A Possible Biomarker for Pulmonary Diseases?

et al. 2018

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Background: Detection of surfactant proteins A and D (SP-A and SP-D) in the serum of patients with pulmonary diseases is thought to reflect an injury of the alveolar epithelial barrier and as such serve as a biomarker for these diseases. However, the data for SP-B are limited. Objectives: The aim of this feasibility study was to assess whether immature SP-B pre-proteins might have value as a possible biomarker for pulmonary diseases. Methods: In serum samples from patients with different chronic lung diseases (interstitial lung diseases [ILDs], chronic obstructive pulmonary disease, asthma, lung cancer, pulmonary hypertension, inflammation, patients on ventilator support; total n = 283), C-proSP-B was measured using an electrochemiluminescence immunoassay based on mouse monoclonal anti-C-proSP-B antibodies. Levels were correlated to lung functional and clinical parameters. Results: The highest C-proSP-B levels were detected in the serum of idiopathic pulmonary fibrosis (IPF) patients. In a multivariate analysis, C-proSP-B levels were able to discriminate IPF patients from patients with all other pulmonary diseases (p < 0.0001). No significant correlations were found between C-proSP-B levels and lung function, smoking history, or disease extent. Conclusions: SP-B pre-proteins might serve as a biomarker in pulmonary diseases with alveolar or interstitial damage such as ILDs, especially in IPF. Their role in the long-term monitoring of such diseases has to be clarified further.

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Surfactant protein B and RAGE increases in the plasma during cardiopulmonary bypass: a pilot study

Cited by 31 publications

References 45 publications

Association between Preoperative Plasma sRAGE Levels and Recovery from Cardiac Surgery

Association between Preoperative Plasma sRAGE Levels and Recovery from Cardiac Surgery

The role of plasma gelsolin in cardiopulmonary bypass induced acute lung injury in infants and young children: a pilot study

C-proSP-B: A Possible Biomarker for Pulmonary Diseases?

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