title: CSF high-mobility group box 1 is associated with intrathecal inflammation and astrocytic damage in neuromyelitis optica.
abstract: OBJECTIVE
  High-mobility group box 1 (HMGB1) acts as a proinflammatory mediator when released by cells. Recent studies implicate extracellular HMGB1 in the pathogenesis of various autoimmune diseases. Our main aim of this study is to determine whether HMGB1 is involved in the neuromyelitis optica (NMO) inflammatory process.
  
  
  METHODS
  Cerebrospinal fluid (CSF) and serum HMGB1 levels in 42 NMO patients were compared with those in 30 multiple sclerosis (MS) patients, and 30 patients with other noninflammatory neurological disorders (ONNDs). We also tested the possible correlation between CSF HMGB1 levels and the clinical and laboratory variables in NMO patients.
  
  
  RESULTS
  CSF HMGB1 levels in NMO patients were higher than those in MS and ONNDs patients (p<0.001), and these levels in MS patients were higher than those in ONNDs patients (p<0.001). After treatment, the CSF HMGB1 levels in NMO patients decreased to normal. In addition, CSF HMGB1 levels correlated with CSF cell counts, CSF protein levels, CSF interleukin-6 levels, CSF glial fibrillary acidic protein levels, and CSF/serum albumin ratio (p≤0.001). Serum HMGB1 levels in MS patients were significantly higher than those in ONNDs patients (p=0.002).
  
  
  CONCLUSIONS
  HMGB1 could play a key role in central nervous system inflammation in NMO patients.
authors.affiliation: Department of Neurology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba 260-8670, Japan. auzawa@chiba-u.jp
authors.forename: Akiyuki
authors.initials: A
authors.lastname: Uzawa
authors.forename: Masahiro
authors.initials: M
authors.lastname: Mori
authors.forename: Saeko
authors.initials: S
authors.lastname: Masuda
authors.forename: Mayumi
authors.initials: M
authors.lastname: Muto
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kuwabara
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001253:Astrocytes / Q000473:pathology*; D004185:Disability Evaluation; D005260:Female; D005904:Glial Fibrillary Acidic Protein / Q000134:cerebrospinal fluid; D024243:HMGB1 Protein / Q000097:blood / Q000134:cerebrospinal fluid*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015850:Interleukin-6 / Q000134:cerebrospinal fluid; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000134:cerebrospinal fluid / Q000235:genetics / Q000473:pathology; D009187:Myelitis / Q000097:blood / Q000134:cerebrospinal fluid* / Q000473:pathology*; D009422:Nervous System Diseases / Q000134:cerebrospinal fluid / Q000473:pathology; D009471:Neuromyelitis Optica / Q000134:cerebrospinal fluid* / Q000473:pathology*; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D005904:Glial Fibrillary Acidic Protein; D024243:HMGB1 Protein; D007166:Immunosuppressive Agents; D015850:Interleukin-6