Peripheral circulatory concentration of soluble receptor for advanced glycation end products (sRAGE) and tumor necrosis factor-α (TNF-α) as biomarkers for congenital heart disease in children with and without Down syndrome

In congenital heart disease and Down syndrome, inflammatory cytokines such as TNF-α increase. In contrast, RAGE is a multi-ligand cell surface receptor mediating inflammation in many diseases. Soluble RAGE (sRAGE) has been well studied for its potential as a decoy for RAGE. This study aims to evaluate the potential of both sRAGE and TNF-α biomarkers for CHD in both DS and non-DS children.We performed an analytic descriptive study utilizing a cross-sectional design. Blood samples were drawn from patients attending the child-health outpatient clinics of Dr. Sardjito Hospital that adhered to our inclusion criteria. Variables were presented using 95% CI and a p-value of 0.05. A ROC was performed to evaluate the potential of both sRAGE and TNF-α as biomarkers. Twenty-seven CHD patients were included, consisting of 13 (48.1%) DS and 14 (51.9%) non-DS children. The area under the curve (AUC) of sRAGE and TNF-α to assess CHD in DS was 0.692 (95% CI 1.11 - 4.89) and 0.621 (95% CI 1.58 - 4.78), respectively. An optimal cut-off point of 357.5 pg./mL (sensitivity 53.8%, specificity 85.7%) was determined for sRAGE and 113.55 ng/L (sensitivity 38.5%, specificity 100%) for TNF-α in DS children. Both sRAGE and TNF-α have the potential to be utilized as biomarkers of CHD, especially for children with DS.