title: The potential role of advanced glycation end products (AGEs) and soluble receptors for AGEs (sRAGE) in the pathogenesis of adult-onset still's disease.
abstract: BACKGROUND
  Accumulating evidence has demonstrated a pathogenic role of advanced glycation end products (AGEs) and receptors for AGEs (RAGE) in inflammation. Soluble RAGE (sRAGE), with the same ligands-binding capacity as full-length RAGE, acts as a "decoy" receptor. However, there has been scanty data regarding AGEs and sRAGE in adult-onset Still's disease (AOSD). This study aimed to investigate AGEs and sRAGE levels in AOSD patients and examine their association with clinical characteristics.
  
  
  METHODS
  Using ELISA, plasma levels of AGEs and sRAGE were determined in 52 AOSD patients, 36 systemic lupus erythematosus(SLE) patients and 16 healthy controls(HC). Their associations with activity parameters and disease courses were evaluated.
  
  
  RESULTS
  Significantly higher median levels of AGEs were observed in active AOSD patients (16.75 pg/ml) and active SLE patients (14.80 pg/ml) than those in HC (9.80 pg/ml, both p < 0.001). AGEs levels were positively correlated with activity scores (r = 0.836, p < 0.001), ferritin levels (r = 0.372, p < 0.05) and CRP levels (r = 0.396, p < 0.005) in AOSD patients. Conversely, significantly lower median levels of sRAGE were observed in active AOSD patients (632.2 pg/ml) and active SLE patients (771.6 pg/ml) compared with HC (1051.7 pg/ml, both p < 0.001). Plasma sRAGE levels were negatively correlated with AOSD activity scores (r = -0.320, p < 0.05). In comparison to AOSD patients with monocyclic pattern, significantly higher AGEs levels were observed in those with polycyclic or chronic articular pattern. With treatment, AGEs levels declined while sRAGE levels increased in parallel with the decrease in disease activity.
  
  
  CONCLUSIONS
  The elevation of AGEs levels with concomitant decreased sRAGE levels in active AOSD patients, suggests their pathogenic role in AOSD.
authors.affiliation: Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan. dychen@vghtc.gov.tw.|Department of Medical Education and Research, Taichung Veterans General Hospital, Taichung, Taiwan. dychen@vghtc.gov.tw.|Institute of Biomedical Science, National Chung-Hsing University, Taichung, Taiwan. dychen@vghtc.gov.tw.|Institute of Microbiology and Immunology, Chung-Shan Medical University, Taichung, Taiwan. dychen@vghtc.gov.tw.|Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, No. 160, Sec. 3, Chung-Kang Rd., Taichung, 407, Taiwan. dychen@vghtc.gov.tw.
authors.forename: Der-Yuan
authors.initials: DY
authors.lastname: Chen
authors.affiliation: Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan. ymchen1@vghtc.gov.tw.|Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung, Taiwan. ymchen1@vghtc.gov.tw.
authors.forename: Yi-Ming
authors.initials: YM
authors.lastname: Chen
authors.affiliation: Institute of Biomedical Science, National Chung-Hsing University, Taichung, Taiwan. lincc@dragon.nchu.edu.tw.
authors.forename: Chi-Chen
authors.initials: CC
authors.lastname: Lin
authors.affiliation: Institute of Biomedical Science, National Chung-Hsing University, Taichung, Taiwan. chiaweih@gmail.com.|Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung, Taiwan. chiaweih@gmail.com.
authors.forename: Chia-Wei
authors.initials: CW
authors.lastname: Hsieh
authors.affiliation: Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung, Taiwan. yencwu@vghtc.gov.tw.
authors.forename: Yen-Ching
authors.initials: YC
authors.lastname: Wu
authors.affiliation: Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan. wthung@vghtc.gov.tw.|Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung, Taiwan. wthung@vghtc.gov.tw.
authors.forename: Wei-Ting
authors.initials: WT
authors.lastname: Hung
authors.affiliation: Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan. shc5555@hotmail.com.|Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung, Taiwan. shc5555@hotmail.com.
authors.forename: Hsin-Hua
authors.initials: HH
authors.lastname: Chen
authors.affiliation: Division of Immunology and Rheumatology, China Medical University Hospital, Taichung, Taiwan. jounglan2003@yahoo.com.tw.
authors.forename: Joung-Liang
authors.initials: JL
authors.lastname: Lan
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D017127:Glycation End Products, Advanced / Q000097:blood*; D006801:Humans; D016015:Logistic Models; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D000067759:Receptor for Advanced Glycation End Products / Q000097:blood*; D012720:Severity of Illness Index; D016706:Still's Disease, Adult-Onset / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy; D055815:Young Adult
chemical_list: C000593871:AGER protein, human; D015415:Biomarkers; D017127:Glycation End Products, Advanced; D000067759:Receptor for Advanced Glycation End Products