Inhibition of the RAGE products increases survival in experimental models of severe sepsis and systemic infection

Crit Care. 2007;11(6):R122. doi: 10.1186/cc6184.

Abstract

Introduction: The receptor for advanced glycation end products (RAGE), a multi-ligand member of the immunoglobulin superfamily, contributes to acute and chronic disease processes, including sepsis.

Methods: We studied the possible therapeutic role of RAGE inhibition in the cecal ligation and puncture (CLP) model of polymicrobial sepsis and a model of systemic listeriosis using mice genetically deficient in RAGE expression or mice injected with a rat anti-murine RAGE monoclonal antibody.

Results: The 7-day survival rates after CLP were 80% for RAGE-/- mice (n = 15) (P < 0.01 versus wild-type), 69% for RAGE+/- mice (n = 23), and 37% for wild-type mice (n = 27). Survival benefits were evident in BALB/c mice given anti-RAGE antibody (n = 15 per group) over serum-treated control animals (P < 0.05). Moreover, delayed treatment with anti-RAGE antibody up to 24 hours after CLP resulted in a significant survival benefit compared with control mice. There was no significant increase in tissue colony counts from enteric Gram-negative or Gram-positive bacteria in animals treated with anti-RAGE antibody. RAGE-/-, RAGE+/-, and anti-RAGE antibody-treated animals were resistant to lethality from Listeria monocytogenes by almost two orders of magnitude compared with wild-type mice.

Conclusion: Further studies are warranted to determine the clinical utility of anti-RAGE antibody as a novel treatment for sepsis.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antibodies, Monoclonal / therapeutic use
  • Disease Models, Animal
  • Glycation End Products, Advanced / antagonists & inhibitors
  • Glycation End Products, Advanced / biosynthesis
  • Glycation End Products, Advanced / genetics
  • Listeriosis / metabolism*
  • Listeriosis / mortality
  • Listeriosis / therapy*
  • Male
  • Mice
  • Mice, Inbred BALB C
  • Mice, Knockout
  • Receptor for Advanced Glycation End Products
  • Receptors, Immunologic / antagonists & inhibitors*
  • Receptors, Immunologic / biosynthesis*
  • Receptors, Immunologic / genetics
  • Receptors, Immunologic / immunology
  • Sepsis / genetics
  • Sepsis / mortality*
  • Sepsis / therapy*
  • Survival Rate
  • Systemic Inflammatory Response Syndrome / metabolism
  • Systemic Inflammatory Response Syndrome / mortality
  • Systemic Inflammatory Response Syndrome / therapy

Substances

  • Antibodies, Monoclonal
  • Glycation End Products, Advanced
  • Receptor for Advanced Glycation End Products
  • Receptors, Immunologic