Elevation of soluble form of receptor for advanced glycation end products (sRAGE) in recurrent pregnancy losses (RPL): Possible participation of RAGE in RPL

Objective To determine whether the soluble receptor for advanced glycation end products (sRAGE) and immune inflammatory markers are associated with recurrent pregnancy losses (RPL). Design Prospective case-control study. Setting University clinic. Patient(s) A total of 93 women (age 35.8 ± 4.6 years) were enrolled including 63 women with three or more recurrent pregnancy losses (RPL), and age-matched fertile controls with a history of at least one live birth and no history of pregnancy losses (n = 30). Intervention(s) Peripheral blood collection. Main Outcome Measure(s) Assessment of anthropometric, metabolic, and inflammatory immune variables. Result(s) Levels of sRAGE were statistically significantly higher in RPL patients than in control patients (1,528.9 ± 704.5 vs. 1,149.9 ± 447.4 pg/mL). In the multivariate analysis, the levels of insulin, plasminogen activator inhibitor-1, the resistance index of the uterine radial artery, and the ratio of tumor necrosis factor-α/interleukin-10 producing T helper cells were statistically significantly associated with the serum sRAGE level. Conclusion(s) Elevated levels of serum sRAGE are associated with RPL. The soluble receptor for advanced glycation end products might contribute to RPL by reducing uterine blood flow and subsequently causing ischemia in the fetus via inflammatory and thrombotic reactions.