High-mobility group box 1 protein plasma concentrations during septic shock.
OBJECTIVE
To investigate plasma high-mobility group box 1 protein (HMGB1) concentration and its relationship with organ dysfunction and outcome in septic shock patients.


METHODS
Prospective, noninterventional study. Medical adult intensive care unit at a university hospital in France.


METHODS
42 critically ill patients with septic shock.


METHODS
Arterial blood was drawn within 12 h of admission for the measurement of plasma HMGB1 concentration by ELISA. Repeated sampling was performed on days 3, 7, and 14.


RESULTS
Median HMGB1 concentration was 4.4 ng/ml (IQR 1.2-12.5) at admission, with no difference between survivors and nonsurvivors. A positive correlation was observed between HMGB1 and SOFA score and lactate, and procalcitonin concentrations. There was a progressive but statistically nonsignificant decline in HMGB1 concentration among the survivors, while nonsurvivors showed an increase in HMGB1 level between days 1 and 3. SOFA score and lactate and procalcitonin concentrations did not vary significantly between days 1 and 3. When measured on day 3, HMGB1 discriminated survivors from nonsurvivors with 66% sensitivity and 67% specificity, and concentration greater than 4 ng/ml was associated with an odds ratio of death of 5.5 (95% CI 1.3-23.6).
Gibot
Sébastien
S
Hôpital Central, Service de Réanimation Médicale, 29 avenue du Maréchal de Lattre de Tassigny, 54000, Nancy, France. s.gibot@chu-nancy.fr
Massin
Frédéric
F
Cravoisy
Aurélie
A
Barraud
Damien
D
Nace
Lionel
L
Levy
Brune
B
Bollaert
Pierre-Edouard
PE
D000368:Aged; D015415:Biomarkers; D002116:Calcitonin / Q000032:analysis / Q000097:blood / Q000378:metabolism; D015740:Calcitonin Gene-Related Peptide; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005602:France; D024243:HMGB1 Protein / Q000032:analysis* / Q000097:blood / Q000378:metabolism; D006801:Humans; D007249:Inflammation / Q000378:metabolism; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000503:physiopathology; D011446:Prospective Studies; D011498:Protein Precursors / Q000032:analysis / Q000097:blood / Q000378:metabolism; D012772:Shock, Septic / Q000378:metabolism* / Q000503:physiopathology
D015415:Biomarkers; C000606589:CALCA protein, human; D024243:HMGB1 Protein; D011498:Protein Precursors; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide