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Klebsiella  species is the second most commonly isolated gram-negative organism in sepsis and a frequent causative pathogen in pneumonia. The receptor for advanced glycation end products (RAGE) is expressed on different cell types and plays a key role in diverse inflammatory responses. We here aimed to investigate the role of RAGE in the host response to  Klebsiella  ( K .)  pneumoniae  pneumonia and intransally inoculated  rage  gene deficient (RAGE -/- ) and normal wild-type (Wt) mice with  K .  pneumoniae .  Klebsiella  pneumonia resulted in an increased pulmonary expression of RAGE. Furthermore, the high-affinity RAGE ligand high mobility group box-1 was upregulated during  K .  pneumoniae  pneumonia. RAGE deficiency impaired host defense as reflected by a worsened survival, increased bacterial outgrowth and dissemination in RAGE -/-  mice. RAGE -/-  neutrophils showed a diminished phagocytosing capacity of live  K .  pneumoniae in vitro . Relative to Wt mice, RAGE -/-  mice demonstrated similar lung inflammation, and slightly elevated—if any—cytokine and chemokine levels and unchanged hepatocellular injury. In addition, RAGE -/-  mice displayed an unaltered response to intranasally instilled  Klebsiella  lipopolysaccharide (LPS) with respect to pulmonary cell recruitment and local release of cytokines and chemokines. These data suggest that (endogenous) RAGE protects against  K .  pneumoniae  pneumonia. Also, they demonstrate that RAGE contributes to an effective antibacterial defense during  K .  pneumoniae  pneumonia, at least partly via its participation in the phagocytic properties of professional granulocytes. Additionally, our results indicate that RAGE is not essential for the induction of a local and systemic inflammatory response to either intact  Klebsiella  or  Klebsiella  LPS.

Receptor for Advanced Glycation End Products (RAGE) Serves a Protective Role during Klebsiella pneumoniae - Induced Pneumonia