title: Plasma concentrations and importance of High Mobility Group Box protein in the prognosis of organ failure in patients with disseminated intravascular coagulation.
abstract: High Mobility Group Box chromosomal protein 1 (HMGB1) is a nuclear DNA-binding protein acting as a proinflammatory cytokine when released in the extracellular space from necrotic cells,activated macrophages and dendritic cells. HMGB1 acts on a specific receptor, RAGE (receptor for advanced glycation end-products), and induces prolonged inflammation, organ failure, septicaemia and death. The aim of the study was to determine the diagnostic value of plasma HMGB1 concentration and its role in the development of organ failure in patients with disseminated intravascular coagulation (DIC). Plasma HMGB-1 levels were measured in patients with suspected DIC and their relationships with DIC, organ failure and clinical outcome were determined. The study took place at the intensive care facility, Mie University School of Medicine and comprised 201 patients with suspected DIC. Plasma HMGB1 was below the detection limit in normal subjects, but moderately elevated in patients with infectious diseases (4.54 +/- 8.18 ng/ml, mean +/- SD), malignancies (2.15 +/- 5.34 ng/ml),and traumas (6.47 +/- 13.13 ng/ml). DIC was associated with significantly high plasma HMGB1 (14.05 +/- 12.56 ng/ml) in these patients. The highest HMGB1 levels were in patients with organ failure (8.29 +/- 10.99 ng/ml) and non-survivors (16.58 +/- 11.01 ng/ml). HMGB1 plasma levels correlated with the DIC score and sepsis-related organ failure assessment (SOFA) score. In conclusion, our data suggest that HMGB-1 is a potentially suitable prognostic marker of OF or DIC.
authors.affiliation: Department of Emergency Medicine, Mie University School of Medicine, Mie, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Hatada
authors.forename: Hideo
authors.initials: H
authors.lastname: Wada
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Nobori
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Okabayashi
authors.forename: Kazuo
authors.initials: K
authors.lastname: Maruyama
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Abe
authors.forename: Shinji
authors.initials: S
authors.lastname: Uemoto
authors.forename: Shingo
authors.initials: S
authors.lastname: Yamada
authors.forename: Ikuro
authors.initials: I
authors.lastname: Maruyama
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D004211:Disseminated Intravascular Coagulation / Q000097:blood* / Q000401:mortality; D005260:Female; D024243:HMGB1 Protein / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000097:blood* / Q000401:mortality; D011237:Predictive Value of Tests; D011379:Prognosis; D015996:Survival Rate
chemical_list: D015415:Biomarkers; D024243:HMGB1 Protein