title: [Relation between serum levels of high mobility group box 1 and hepatitis B virus-related acute-on-chronic liver failure].
abstract: OBJECTIVE
  To evaluate the levels of high mobility group box 1 protein (HMGB1) in serum of patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF) and investigate its potential relation to the clinical features of these patients.
  
  
  METHODS
  Sixty patients with HBV-related ACLF, 30 patients with chronic hepatitis B (CHB), and 24 healthy individuals (controls) were enrolled in the study. Markers of liver function, such as aspartate aminotransferase (AST), were measured by routine biochemical methods. Imaging studies, such as abdominal computed tomography or magnetic resonance imaging, were used for disease staging. Serum levels of HMGB1 were measured by ELISA. Deaths within the 2-month follow-up after serum collection were used for the survival analysis. Patients who developed peritonitis, pneumonia, or other bacterial and fungal infections during the 2-month follow-up after serum collection were classified as the infected group. Pairwise comparisons were carried out by t-test, and multiple comparisons were carried out by analysis of variance.
  
  
  RESULTS
  Patients with HBV-related ACLF had significantly higher serum levels of HMGB1 than CHB patients or controls (P = 0.003). Among the patients with HBV-related ACLF, those in the late stage (n = 20) had significantly higher levels of HMGB1 than those in the early stage (n = 20) (P = 0.005). The serum levels of HMGB1 correlated well with AST level in patients with HBV-related ACLF (P = 0.006). In addition, patients with HBV-related ACLF who developed infection or died during follow-up also had significantly higher levels of HMGB1 (P = 0.028 or P = 0.017, respectively).
  
  
  CONCLUSIONS
  Enhanced serum level of HMGB1 is associated with development of HBV-related ACLF in CHB patients. The strong correlation between HMGB1 and AST levels suggest that HMGB1 may be useful as a prognostic marker for development of ACLF.
authors.affiliation: Liver Failure Treatment and Research Center, 302 Military Hospital, Beijing 100039, China.
authors.forename: Xue-zhang
authors.initials: XZ
authors.lastname: Duan
authors.forename: Jin-hua
authors.initials: JH
authors.lastname: Hu
authors.forename: Chen
authors.initials: C
authors.lastname: Li
authors.forename: Fang-fang
authors.initials: FF
authors.lastname: Liu
authors.forename: Xiao-yan
authors.initials: XY
authors.lastname: Liu
authors.forename: Jing-jing
authors.initials: JJ
authors.lastname: Tong
authors.forename: Shao-jie
authors.initials: SJ
authors.lastname: Xin
mesh_terms: D000293:Adolescent; D000328:Adult; D001219:Aspartate Aminotransferases / Q000378:metabolism; D016022:Case-Control Studies; D005260:Female; D024243:HMGB1 Protein / Q000097:blood*; D006515:Hepatitis B virus; D019694:Hepatitis B, Chronic / Q000097:blood*; D006801:Humans; D017093:Liver Failure / Q000097:blood*; D017114:Liver Failure, Acute / Q000097:blood*; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: D024243:HMGB1 Protein; D001219:Aspartate Aminotransferases