title: Level of secreted HMGB1 correlates with severity of inflammation in chronic rhinosinusitis.
abstract: OBJECTIVE
  High mobility group box 1 (HMGB1) protein is a chromatin protein that functions as a proinflammatory cytokine when secreted in response to inflammatory stimuli. The purpose of this study was to determine the relationship between the HMGB1 level in nasal secretions and the severity of inflammation in chronic rhinosinusitis.
  
  
  METHODS
  This was a cross-sectional study.
  
  
  METHODS
  Nasal secretions were obtained by irrigation of the affected sinonasal cavities with normal saline. Total 63 nasal lavage fluid samples were collected from 38 patients with chronic rhinosinusitis who underwent endoscopic sinus surgery. Levels of HMGB1 and tumor necrosis factor alpha, interleukin (IL)-1β, and IL-8 were determined by enzyme-linked immunoassay. Severity of inflammation was assessed by the Lund-Mackay scoring system, which is based on preoperative computed tomography scans. Concurrent medical disorders, presence of nasal polyps, septal deviation, and allergic rhinitis were also investigated.
  
  
  RESULTS
  The level of HMGB1 in nasal lavage fluid was positively correlated with the Lund-Mackay score. The score was the only factor associated with HMGB1 by univariate and multivariate analysis. Other cytokines, with the exception of IL-8, were not correlated with the Lund-Mackay score.
  
  
  CONCLUSIONS
  Our results showed that HMGB1 is secreted into the extracellular area space in the upper airway, and HMGB1 levels in nasal lavage fluid correlate with severity of inflammation, as assessed by the Lund-Mackay staging system for chronic rhinosinusitis. These results provide evidence for HMGB1 as an inflammatory mediator associated with the severity of chronic rhinosinusitis.
authors: Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea.|Airway Mucus Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors: Hyun Jin
authors: HJ
authors: Min
authors: Airway Mucus Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.|Research Center for Human Natural Defense System, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors: Su Jin
authors: SJ
authors: Kim
authors: Airway Mucus Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.|Research Center for Human Natural Defense System, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors: Tae Hoon
authors: TH
authors: Kim
authors: Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea.|Airway Mucus Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors: Hyo Jin
authors: HJ
authors: Chung
authors: Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea.|Airway Mucus Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors: Joo-Heon
authors: JH
authors: Yoon
authors: Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea.|Airway Mucus Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors: Chang-Hoon
authors: CH
authors: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D024243:HMGB1 Protein / Q000378:metabolism*; D006801:Humans; D007150:Immunohistochemistry; D007249:Inflammation / Q000378:metabolism*; D053583:Interleukin-1beta / Q000378:metabolism; D016209:Interleukin-8 / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D017817:Nasal Lavage Fluid; D012220:Rhinitis / Q000150:complications / Q000378:metabolism*; D012720:Severity of Illness Index; D012852:Sinusitis / Q000150:complications / Q000378:metabolism*; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism; D055815:Young Adult
chemical_list: D024243:HMGB1 Protein; D053583:Interleukin-1beta; D016209:Interleukin-8; D014409:Tumor Necrosis Factor-alpha
keywords: HMGB1; Lund-Mackay score; nasal lavage