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Predictive value of combination of lung injury prediction score and receptor for advanced glycation end‑products for the occurrence of acute respiratory distress syndrome

  • Authors:
    • Jun Yang
    • Ai Wei
    • Bing Wu
    • Jialin Deng
  • View Affiliations / Copyright

    Affiliations: Department of Critical Care Medicine, Chongqing University Jiangjin Hospital, Chongqing 402260, P.R. China, Department of Nursing, Chongqing University Jiangjin Hospital, Chongqing 402260, P.R. China
    Copyright: © Yang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 4
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    Published online on: November 8, 2023
       https://doi.org/10.3892/etm.2023.12291
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Abstract

The present study evaluated the predictive value of the combination of the lung injury prediction score (LIPS) and receptor for advanced glycation end‑products (RAGE) for the occurrence of acute respiratory distress syndrome (ARDS) in critically ill patients with ARDS risk factors. A total of 551 patients with risk factors of ARDS were divided into an ARDS group and a non‑ARDS group. LIPS was computed within 6 h of admission into the ICU, and the plasma concentration of RAGE was detected within 24 h of admission. Multivariate analysis was performed to identify independent associations, and the predictive values for ARDS occurrence were assessed with receiver operating characteristic (ROC) curve. Within 7 days after admission into the ICU, ARDS occurred in 176 patients (31.9%). Multivariate analysis demonstrated that LIPS [odds ratio (OR), 1.282; 95% confidence interval (CI), 1.108‑1.604], RAGE levels (OR, 2.359; 95% CI, 1.351‑4.813) and Acute Physiology and Chronic Health Evaluation II score (OR, 1.167; 95% CI, 1.074‑1.485) were independently associated with ARDS occurrence. ROC curves demonstrated that the area under curve (AUC) of LIPS, RAGE levels and their combination was 0.714 [standard error (SE), 0.023; 95% CI, 0.670‑0.759], 0.709 (SE, 0.025; 95% CI, 0.660‑0.758) and 0.889 (SE, 0.014; 95% CI, 0.861‑0.917), respectively. The AUC of LIPS combined with RAGE levels was significantly higher compared with those of LIPS (0.889 vs. 0.714; Z=6.499; P<0.001) and RAGE (0.889 vs. 0.709; Z=6.282; P<0.001) levels alone. In conclusion, both LIPS and RAGE levels were independently associated with ARDS occurrence in critically ill patients with ARDS risk factors, and had medium predictive values for ARDS occurrence. Combination of LIPS with RAGE levels increased the predictive value for ARDS occurrence.
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1 

ARDS Definition Task Force. Ranieri VM, Rubenfeld GD, Thompson BT, Ferguson ND, Caldwell E, Fan E, Camporota L and Slutsky AS: Acute respiratory distress syndrome: The Berlin Definition. JAMA. 307:2526–33. 2012.PubMed/NCBI View Article : Google Scholar

2 

Villar J, Pérez-Méndez L, Blanco J, Añón JM, Blanch L, Belda J, Santos-Bouza A, Fernández RL and Kacmarek RM: Spanish initiative for epidemiology, stratification and therapies for ARDS (SIESTA) network. A universal definition of ARDS: the PaO2/FiO2 ratio under a standard ventilatory setting-a prospective, multicenter, validation study. Intensive Care Med. 39:583–92. 2013.PubMed/NCBI View Article : Google Scholar

3 

García-Laorden MI, Lorente JA, Flores C, Slutsky AS and Villar J: Biomarkers for the acute respiratory distress syndrome: how to make the diagnosis more precise. Ann Transl Med. 5(283)2017.PubMed/NCBI View Article : Google Scholar

4 

Matthay MA, Zemans RL, Zimmerman GA, Arabi YM, Beitler JR, Mercat A, Herridge M, Randolph AG and Calfee CS: Acute respiratory distress syndrome. Nat Rev Dis Primers. 5(18)2019.PubMed/NCBI View Article : Google Scholar

5 

Villar J, Blanco J and Kacmarek RM: Current incidence and outcome of the acute respiratory distress syndrome. Curr Opin Crit Care. 22:1–6. 2016.PubMed/NCBI View Article : Google Scholar

6 

Bellani G, Laffey JG, Pham T, Fan E, Brochard L, Esteban A, Gattinoni L, van Haren F, Larsson A, McAuley DF, et al: Epidemiology, patterns of care, and mortality for patients with acute respiratory distress syndrome in intensive care units in 50 countries. JAMA. 315:788–800. 2016.PubMed/NCBI View Article : Google Scholar

7 

Trillo-Alvarez C, Cartin-Ceba R, Kor DJ, Kojicic M, Kashyap R, Thakur S, Thakur L, Herasevich V, Malinchoc M and Gajic O: Acute lung injury prediction score: Derivation and validation in a population-based sample. Eur Respir J. 37:604–609. 2011.PubMed/NCBI View Article : Google Scholar

8 

Soto GJ, Kor DJ, Park PK, Hou PC, Kaufman DA, Kim M, Yadav H, Teman N, Hsu MC, Shvilkina T, et al: Lung injury prediction score in hospitalized patients at risk of acute respiratory distress syndrome. Crit Care Med. 44:2182–2191. 2016.PubMed/NCBI View Article : Google Scholar

9 

Zheng F, Pan Y, Yang Y, Zeng C, Fang X, Shu Q and Chen Q: Novel biomarkers for acute respiratory distress syndrome: genetics, epigenetics and transcriptomics. Biomark Med. 16:217–231. 2022.PubMed/NCBI View Article : Google Scholar

10 

Yadav H, Bartley A, Keating S, Meade LA, Norris PJ, Carter RE, Gajic O and Kor DJ: Evolution of validated biomarkers and intraoperative parameters in the development of postoperative ARDS. Respir Care. 63:1331–1340. 2018.PubMed/NCBI View Article : Google Scholar

11 

Zhu Z, Liang L, Zhang R, Wei Y, Su L, Tejera P, Guo Y, Wang Z, Lu Q, Baccarelli AA, et al: Whole blood microRNA markers are associated with acute respiratory distress syndrome. Intensive Care Med Exp. 5(38)2017.PubMed/NCBI View Article : Google Scholar

12 

Xu Z, Wu GM, Li Q, Ji FY, Shi Z, Guo H, Yin JB, Zhou J, Gong L, Mei CX and Wang GS: Predictive value of combined LIPS and ANG-2 level in critically ill patients with ARDS risk factors. Mediators Inflamm. 2018(1739615)2018.PubMed/NCBI View Article : Google Scholar

13 

van der Zee P, Rietdijk W, Somhorst P, Endeman H and Gommers D: A systematic review of biomarkers multivariately associated with acute respiratory distress syndrome development and mortality. Crit Care. 24(243)2020.PubMed/NCBI View Article : Google Scholar

14 

Gajic O, Dabbagh O, Park PK, Adesanya A, Chang SY, Hou P, Anderson H III, Hoth JJ, Mikkelsen ME, Gentile NT, et al: Early identification of patients at risk of acute lung injury: Evaluation of lung injury prediction score in a multicenter cohort study. Am J Respir Crit Care Med. 183:462–70. 2011.PubMed/NCBI View Article : Google Scholar

15 

Bone RC, Balk RA, Cerra FB, Dellinger RP, Fein AM, Knaus WA, Schein RM and Sibbald WJ: Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM consensus conference committee. American college of chest physicians/society of critical care medicine. Chest. 101:1644–1655. 1992.PubMed/NCBI View Article : Google Scholar

16 

Li G, Malinchoc M, Cartin-Ceba R, Venkata CV, Kor DJ, Peters SG, Hubmayr RD and Gajic O: Eight-year trend of acute respiratory distress syndrome: a population-based study in Olmsted County, Minnesota. Am J Respir Crit Care Med. 183:59–66. 2011.PubMed/NCBI View Article : Google Scholar

17 

Yadav H, Thompson BT and Gajic O: Fifty years of research in ARDS. Is acute respiratory distress syndrome a preventable disease? Am J Respir Crit Care Med. 195:725–736. 2017.PubMed/NCBI View Article : Google Scholar

18 

Kaku S, Nguyen CD, Htet NN, Tutera D, Barr J, Paintal HS and Kuschner WG: Acute respiratory distress syndrome: Etiology, pathogenesis, and summary on management. J Intensive Care Med. 35:723–737. 2020.PubMed/NCBI View Article : Google Scholar

19 

Zarbock A, Singbartl K and Ley K: Complete reversal of acid-induced acute lung injury by blocking of platelet-neutrophil aggregation. J Clin Invest. 116:3211–3219. 2006.PubMed/NCBI View Article : Google Scholar

20 

Jacobson JR, Barnard JW, Grigoryev DN, Ma SF, Tuder RM and Garcia JG: Simvastatin attenuates vascular leak and inflammation in murine inflammatory lung injury. Am J Physiol Lung Cell Mol Physiol. 288:L1026–L1032. 2005.PubMed/NCBI View Article : Google Scholar

21 

Kim BK, Kim S, Kim CY, Kim YJ, Lee SH, Cha JH and Kim JH: Predictive role of lung injury prediction score in the development of acute respiratory distress syndrome in Korea. Yonsei Med J. 62:417–423. 2021.PubMed/NCBI View Article : Google Scholar

22 

Thompson BT, Chambers RC and Liu KD: Acute respiratory distress syndrome. N Engl J Med. 377:562–572. 2017.PubMed/NCBI View Article : Google Scholar

23 

Terpstra ML, Aman J, van Nieuw Amerongen GP and Groeneveld AB: Plasma biomarkers for acute respiratory distress syndrome: A systematic review and meta-analysis*. Crit Care Med. 42:691–700. 2014.PubMed/NCBI View Article : Google Scholar

24 

Xie J, Méndez JD, Méndez-Valenzuela V and Aguilar-Hernández MM: Cellular signalling of the receptor for advanced glycation end products (RAGE). Cell Signal. 25:2185–2197. 2013.PubMed/NCBI View Article : Google Scholar

25 

Tóbon-Velasco JC, Cuevas E and Torres-Ramos MA: Receptor for AGEs (RAGE) as mediator of NF-kB pathway activation in neuroinflammation and oxidative stress. CNS Neurol Disord Drug Targets. 13:1615–1626. 2014.PubMed/NCBI View Article : Google Scholar

26 

Nass N, Trau S, Paulsen F, Kaiser D, Kalinski T and Sel S: The receptor for advanced glycation end products RAGE is involved in corneal healing. Ann Anat. 211:13–20. 2017.PubMed/NCBI View Article : Google Scholar

27 

Kwon OS, Decker ST, Zhao J, Hoidal JR, Heuckstadt T, Sanders KA, Richardson RS and Layec G: The receptor for advanced glycation end products (RAGE) is involved in mitochondrial function and cigarette smoke-induced oxidative stress. Free Radic Biol Med. 195:261–269. 2023.PubMed/NCBI View Article : Google Scholar

28 

Walter JM, Wilson J and Ware LB: Biomarkers in acute respiratory distress syndrome: From pathobiology to improving patient care. Expert Rev Respir Med. 8:573–86. 2014.PubMed/NCBI View Article : Google Scholar

29 

Calfee CS, Ware LB, Eisner MD, Parsons PE, Thompson BT, Wickersham N and Matthay MA: NHLBI ARDS Network. Plasma receptor for advanced glycation end products and clinical outcomes in acute lung injury. Thorax. 63:1083–1089. 2008.PubMed/NCBI View Article : Google Scholar

30 

Mauri T, Masson S, Pradella A, Bellani G, Coppadoro A, Bombino M, Valentino S, Patroniti N, Mantovani A, Pesenti A and Latini R: Elevated plasma and alveolar levels of soluble receptor for advanced glycation end-products are associated with severity of lung dysfunction in ARDS patients. Tohoku J Exp Med. 222:105–112. 2010.PubMed/NCBI View Article : Google Scholar

31 

Nakamura T, Sato E, Fujiwara N, Kawagoe Y, Maeda S and Yamagishi S: 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. Clin Biochem. 44:601–604. 2011.PubMed/NCBI View Article : Google Scholar

32 

Jabaudon M, Futier E, Roszyk L, Chalus E, Guerin R, Petit A, Mrozek S, Perbet S, Cayot-Constantin S, Chartier C, et al: Soluble form of the receptor for advanced glycation end products is a marker of acute lung injury but not of severe sepsis in critically ill patients. Crit Care Med. 39:480–488. 2011.PubMed/NCBI View Article : Google Scholar

33 

Fremont RD, Koyama T, Calfee CS, Wu W, Dossett LA, Bossert FR, Mitchell D, Wickersham N, Bernard GR, Matthay MA, et al: Acute lung injury in patients with traumatic injuries: utility of a panel of biomarkers for diagnosis and pathogenesis. J Trauma. 68:1121–1127. 2010.PubMed/NCBI View Article : Google Scholar

34 

Ware LB, Koyama T, Zhao Z, Janz DR, Wickersham N, Bernard GR, May AK, Calfee CS and Matthay MA: Biomarkers of lung epithelial injury and inflammation distinguish severe sepsis patients with acute respiratory distress syndrome. Crit Care. 17(R253)2013.PubMed/NCBI View Article : Google Scholar

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Spandidos Publications style
Yang J, Wei A, Wu B and Deng J: Predictive value of combination of lung injury prediction score and receptor for advanced glycation end‑products for the occurrence of acute respiratory distress syndrome. Exp Ther Med 27: 4, 2024.
APA
Yang, J., Wei, A., Wu, B., & Deng, J. (2024). Predictive value of combination of lung injury prediction score and receptor for advanced glycation end‑products for the occurrence of acute respiratory distress syndrome. Experimental and Therapeutic Medicine, 27, 4. https://doi.org/10.3892/etm.2023.12291
MLA
Yang, J., Wei, A., Wu, B., Deng, J."Predictive value of combination of lung injury prediction score and receptor for advanced glycation end‑products for the occurrence of acute respiratory distress syndrome". Experimental and Therapeutic Medicine 27.1 (2024): 4.
Chicago
Yang, J., Wei, A., Wu, B., Deng, J."Predictive value of combination of lung injury prediction score and receptor for advanced glycation end‑products for the occurrence of acute respiratory distress syndrome". Experimental and Therapeutic Medicine 27, no. 1 (2024): 4. https://doi.org/10.3892/etm.2023.12291
Copy and paste a formatted citation
x
Spandidos Publications style
Yang J, Wei A, Wu B and Deng J: Predictive value of combination of lung injury prediction score and receptor for advanced glycation end‑products for the occurrence of acute respiratory distress syndrome. Exp Ther Med 27: 4, 2024.
APA
Yang, J., Wei, A., Wu, B., & Deng, J. (2024). Predictive value of combination of lung injury prediction score and receptor for advanced glycation end‑products for the occurrence of acute respiratory distress syndrome. Experimental and Therapeutic Medicine, 27, 4. https://doi.org/10.3892/etm.2023.12291
MLA
Yang, J., Wei, A., Wu, B., Deng, J."Predictive value of combination of lung injury prediction score and receptor for advanced glycation end‑products for the occurrence of acute respiratory distress syndrome". Experimental and Therapeutic Medicine 27.1 (2024): 4.
Chicago
Yang, J., Wei, A., Wu, B., Deng, J."Predictive value of combination of lung injury prediction score and receptor for advanced glycation end‑products for the occurrence of acute respiratory distress syndrome". Experimental and Therapeutic Medicine 27, no. 1 (2024): 4. https://doi.org/10.3892/etm.2023.12291
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