High mobility group box-1 expression correlates with poor outcome in lung injury patients.
Chest trauma is frequently followed by pulmonary contusion and sepsis. High mobility group box-1 (HMGB-1) is a late mediator of severe sepsis that has been associated with mortality under experimental conditions. We studied HMGB-1 mRNA expression in patients with lung injury and its relationship with the severity of trauma and survival. A total of 24 consecutive patients with chest trauma referring to the Intensive Care Unit of Messina University Hospital, were enrolled. Lung trauma was established on the basis of chest X-ray and computed tomography. Injury Severity Score (ISS), Revised Trauma Score (RTS) and Glasgow Coma Scale (GCS) were also assessed. Accordingly to these results 6 patients were considered as controls because of no penetrating trauma and low ISS. Blood and broncho-alveolar lavage fluid (BALF) from chest trauma patients were withdrawn at admission and 24h after the beginning of the standard therapeutic protocol. HMGB-1 mRNA increased significantly in blood (r=0.84) and BALF (r=0.87) from patients with trauma and pulmonary contusion and positively correlated with the severity of trauma (based on ISS and RTS) and the final outcome. HMGB-1 protein levels were also elevated in BALF macrophages from severe trauma patients compared to control subjects, furthermore TNF-alpha and its receptor TNFR-1 mRNA levels were also markedly increased in patients with a poor outcome respect to other subjects. Our study suggests that HMGB-1 may be an early indicator of poor clinical outcome in patients with chest trauma.
Bitto
Alessandra
A
Department of Clinical and Experimental Medicine and Pharmacology, Section of Pharmacology, University of Messina, Italy.
Barone
Mario
M
David
Antonio
A
Polito
Francesca
F
Familiari
Dario
D
Monaco
Francesco
F
Giardina
Massimiliano
M
David
Teresa
T
Messina
Roberto
R
Noto
Alberto
A
Di Stefano
Vincenzo
V
Altavilla
Domenica
D
Bonaiuto
Antonio
A
Minutoli
Letteria
L
Guarini
Salvatore
S
Ottani
Alessandra
A
Squadrito
Francesco
F
Venuti
Francesco Saverio
FS
D000293:Adolescent; D000328:Adult; D015153:Blotting, Western; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry; D016022:Case-Control Studies; D015600:Glasgow Coma Scale; D024243:HMGB1 Protein / Q000235:genetics / Q000378:metabolism*; D006801:Humans; D015601:Injury Severity Score; D016014:Linear Models; D055370:Lung Injury / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000401:mortality / Q000628:therapy; D008875:Middle Aged; D012333:RNA, Messenger / Q000378:metabolism; D047888:Receptors, Tumor Necrosis Factor, Type I / Q000235:genetics; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012720:Severity of Illness Index; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000235:genetics; D015854:Up-Regulation; D055815:Young Adult
D024243:HMGB1 Protein; D012333:RNA, Messenger; D047888:Receptors, Tumor Necrosis Factor, Type I; C506235:TNFRSF1A protein, human; D014409:Tumor Necrosis Factor-alpha