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Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 1/2017

Open Access 01-12-2017 | Original research

S100A8/A9 and sRAGE kinetic after polytrauma; an explorative observational study

Authors: Philippe Joly, John C. Marshall, Philippe A. Tessier, Chantal Massé, Nathalie Page, Anne Julie Frenette, François Khazoom, Soazig Le Guillan, Yves Berthiaume, Emmanuel Charbonney

Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine | Issue 1/2017

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Abstract

Background

Following tissue injury after trauma, the activation of innate immune pathways results in systemic inflammation, organ failure and an increased risk of infections. The objective of this study was to characterize the kinetics of the S100A8/S100A9 complex, a new-recognized alarmin, as well as its soluble receptor sRAGE, over time after trauma as potential early biomarkers of the risk of organ damage.

Methods

We collected comprehensive data from consenting patients admitted to an ICU following severe trauma. The blood samples were taken at Day 0 (admission), Day1, 3 and 5 S100A8/A9 and sRAGE were measured by ELISA. Biomarkers levels were reported as median (IQR).

Results

Thirty-eight patients sustaining in majority a blunt trauma (89%) with a median ISS of 39 were included. In this cohort, the S100A8/A9 complex increased significantly over time (p = 0.001), but its levels increment over time (D0 to D5) was significantly smaller in patients developing infection (7.6 vs 40.1 mcg/mL, p = 0.011). The circulating level of sRAGE circulating levels decreased over time (p < 0.0001) and was higher in patients who remained in shock on day 3 (550 vs 918 pg/mL; p = 0.02) or 5 (498 vs 644 pg/mL; p = 0.045). Admission sRAGE levels were significantly higher in non-survivors (1694 vs 745 pg/mL; p = 0.015) and was higher in patients developing renal failure (1143 vs 696 pg/mL, p = 0.011).

Discussion

Our findings reveal an interesting association between the biomarker S100A8/9 least increase over time and the presence of infectious complication after trauma. We describe that the sRAGE decline over time is in relation with shock and markers of ischemic injury. We also confirm the association of sRAGE levels measured at admission with mortality and the development of renal failure.

Conclusions

This work illustrates the importance of following the circulating level of biomarker overtime. The utilization of S1008/9 as a tool to stratify infection risk and trigger early interventions need to be validated prospectively.
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Metadata
Title
S100A8/A9 and sRAGE kinetic after polytrauma; an explorative observational study
Authors
Philippe Joly
John C. Marshall
Philippe A. Tessier
Chantal Massé
Nathalie Page
Anne Julie Frenette
François Khazoom
Soazig Le Guillan
Yves Berthiaume
Emmanuel Charbonney
Publication date
01-12-2017
Publisher
BioMed Central
DOI
https://doi.org/10.1186/s13049-017-0455-0

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