Purpose: Advanced glycation end products (AGEs) are created by non-enzymatic glycation or after their interaction with exact receptors. Facts of the role of the soluble receptor's of advanced glycation end products (sRAGE) in pediatric heart failure (HF) resulting from either idiopathic dilated cardiomyopathy (IDCM) and chronic renal failure (CRF) in children are very limited on the contrary to numerous investigations in adults.
We hypothesized the relationships between plasma levels of sRAGE in IDCM and CRF as well as plasma levels of oxidized low-density lipoprotein (oxLDL), as a marker of oxidative stress and serum levels of high sensitivity C-reactive protein as a marker of inflammation (hsCRP) compared to healthy controls (HC).
Methods: Sixty HF children (aged 4–14 years) were recruited [30 child with IDCM were compared to 30 child with CRF, will be prospectively included in the study, advancing New York Heart Association functional class score (NYHA) will be defined for all patients] and 20 healthy controls HC].Plasma Levels of sRAGE and ox LDL were measured by ELISA and serum hsCRP levels were determined by a nephelometry, arterial blood gases and hemodynamic data were also obtained.
Results: Plasma levels of sRAGE, oxLDL and serum levels hsCRP values were significantly higher in children with CRF compared to HC (p<0.0001). CRF patients had significantly elevated sRAGEs levels compared IDCM patients [1617(1456-1678);1226 (982.5 –1263) ;p<0.0001], respectively. IDCM patients had significantly elevated sRAGEs levels compared HC[1226 (982.5 –1263);820.5 (678 –987);p<0.01], correspondingly. There were significantly higher plasma level of oxLDL and serum levels of hsCRP in CRF and IDCM compared to HC subjects (p< 0.0001). No significance difference in plasma levels of oxLDL in CRF compared to IDCM (p=NS). Significant correlations (Spearman’s rho) were evident between sRAGE and serum level of creatinine in CRF
(r = 0.50; p<0.05).
Conclusions: Abnormal levels of all indices were supposed to be a predictor of HF severity. Findings from these studies will assist clinicians in formative the significance of targeting advanced glycation as a therapeutic approach for reducing cardiovascular diseases complications, which may reflect relative roles in the biology of HF.