Increased of serum high-mobility group box chromosomal protein 1 correlated with intestinal mucosal barrier injury in patients with severe acute pancreatitis.
BACKGROUND
Secondary infections are the leading cause of death in patients with severe acute pancreatitis (SAP). The gut represents the main source of pancreatic contamination and related septic complications. High-mobility group box chromosomal protein 1 (HMGB1) was recently identified to play an important role in the SAP intestinal mucosal barrier dysfunction.


OBJECTIVE
To investigate the correlation of high-mobility group box 1 (HMGB1) with intestinal barrier injury and infections in patients with severe acute pancreatitis (SAP).


METHODS
The serum levels of HMGB1, amylase, lipase, and biochemical indicators were measured in 80 patients with SAP at the time of admission. Furthermore, relationship between their serum HMGB1 levels and intestinal barrier injury, infection and other clinical factors were analyzed.


RESULTS
The mean value of serum HMGB1 levels was significantly higher in patients with SAP (6.02 ± 2.42 ng/mL) than that in healthy volunteers (1.87 ± 0.63 ng/mL). Serum HMGB1 levels were significantly positively correlated with the Ranson score. The HMGB1 levels were higher in patients with infection during the clinical course, the HMGB1 levels in non-survivors were higher than those in survivors, and positively correlated with DAO activity, L/M ratio, the concentration of endotoxin (R = 0.484, P <0.01).


CONCLUSIONS
HMGBl level of patients with severe acute pancreatitis was significantly increased, and can be used as an important indicator to determine the intestinal barrier dysfunction and infection.
Department of Gastroenterology, Nanjing Drum tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China.
Gui-Fang
GF
Xu
Department of Gastroenterology, Drum Tower Clinical College of Nanjing Traditional Chinese Medical University, Nanjing, China.
Ming
M
Guo
Department of General Surgery, 101st Hospital of People's Liberation Army, Wuxi, China.
Zhi-Qiang
ZQ
Tian
Department of General Surgery, 101st Hospital of People's Liberation Army, Wuxi, China.
Guo-Zhong
GZ
Wu
Department of Gastroenterology, Nanjing Drum tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China.
Xiao-Ping
XP
Zou
Department of Emergency, Nanjing Drum tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China.
Wei-Jie
WJ
Zhang
High-mobility group box chromosomal protein 1 (HMGB1); Infection; Inflammation; Injury; Intestinal mucosal barrier; Severe acute pancreatitis