title: Elevated plasma high-mobility group box 1 protein is a potential marker for neuromyelitis optica.
abstract: High-mobility group box 1 protein (HMGB1) has cytokine activities and mediates systemic inflammation as well as immune responses. The aim of this study was to determine if plasma HMGB1 level can be used as a marker for neuromyelitis optica (NMO) and to differentiate NMO from multiple sclerosis (MS). We measured plasma levels of HMGB1, tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), and interleukin 17 (IL-17) in 29 patients with NMO and 20 patients with MS at enrollment and at 2years follow-up (at the time of definitive diagnosis) by enzyme-linked immunosorbent assay. Plasma HMGB1 level was significantly greater in the NMO group compared to the MS group (P<0.001). Plasma levels of TNF-α, IFN-γ, and IL-17 were significantly greater in the NMO group compared to the MS group, and HMGB1 level was positively correlated with TNF-α, IFN-γ, and IL-17 levels. Univariate logistic regression analysis showed a significant association of HMGB1 level, and IFN-γ level with NMO diagnosis. Although this study included a limited sample size, we attempted to determine an optimized cutoff point for HMGB1 (≥2 ng/ml), which provided 89.7% sensitivity and 95.0% specificity for the diagnosis of NMO. These results indicate that plasma HMGB1 level might serve as a surrogate marker for NMO disease activity and aid in the differentiation of NMO from MS at the early disease stage.
authors.affiliation: Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan.
authors.forename: K-C
authors.initials: KC
authors.lastname: Wang
authors.forename: C-P
authors.initials: CP
authors.lastname: Tsai
authors.forename: C-L
authors.initials: CL
authors.lastname: Lee
authors.forename: S-Y
authors.initials: SY
authors.lastname: Chen
authors.forename: L-T
authors.initials: LT
authors.lastname: Chin
authors.forename: S-J
authors.initials: SJ
authors.lastname: Chen
mesh_terms: D000328:Adult; D017668:Age of Onset; D051401:Aquaporin 4 / Q000378:metabolism; D019540:Area Under Curve; D001379:Azathioprine / Q000627:therapeutic use; D015415:Biomarkers; D016207:Cytokines / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D024243:HMGB1 Protein / Q000097:blood*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000188:drug therapy / Q000378:metabolism; D009471:Neuromyelitis Optica / Q000097:blood* / Q000188:drug therapy; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results
chemical_list: D051401:Aquaporin 4; D015415:Biomarkers; D016207:Cytokines; D024243:HMGB1 Protein; D007166:Immunosuppressive Agents; D001379:Azathioprine