title: Thalassaemia major and infectious risk: High Mobility Group Box-1 represents a novel diagnostic and prognostic biomarker.
abstract: High mobility group box -1 (HMGB1) represents a common causal agent for various types of diseases, including infective pathologies. This study aimed to investigate the role of HMGB1 in β-thalassemia major (TM) by evaluating its diagnostic and prognostic role. Fifty-one TM patients and 30 healthy subjects (HS) were enrolled. Receiver operating characteristics (ROC) analysis was employed to calculate the area under the curve (AUC) for HMGB1 to determine the best cut-off values capable of identifying infectious episodes. Adjusted risk estimates for infective events were calculated using univariate followed by multivariate Cox proportional hazard regression analysis. Serum HMGB1 levels were higher in TM patients than in HS (14·6 ± 8·7 vs. 2·08 ± 0·9 ng/ml, P < 0·0001). Patients who underwent splenectomy were characterized by lower levels of HMGB1, when compared with patients with an intact spleen (10·2 ± 8 vs. 19·1 ± 7 ng/ml, P = 0·004). ROC analyses revealed an AUC for serum HMGB1 of 0·801, with a sensitivity and specificity of 92·3% and 68·2% to detect an infectious episode. Low HMGB1 levels predicted high risk of infective events (HR: 0·81; P = 0·006). HMGB1 represents a prognostic marker for TM patients and a predictive factor for infectious events.
authors.affiliation: Department of Paediatric Sciences, University of Messina, Messina, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Chirico
authors.affiliation: Department of Internal Medicine, University of Messina, Messina, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Lacquaniti
authors.affiliation: Department of Paediatric Sciences, University of Messina, Messina, Italy.
authors.forename: Basilia
authors.initials: B
authors.lastname: Piraino
authors.affiliation: Department of Paediatric Sciences, University of Messina, Messina, Italy.
authors.forename: Maricia
authors.initials: M
authors.lastname: Cutrupi
authors.affiliation: Department of Paediatric Sciences, University of Messina, Messina, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Cuppari
authors.affiliation: Department of Paediatric Sciences, University of Messina, Messina, Italy.
authors.forename: Luisa
authors.initials: L
authors.lastname: Grasso
authors.affiliation: Department of Paediatric Sciences, University of Messina, Messina, Italy.
authors.forename: Luciana
authors.initials: L
authors.lastname: Rigoli
authors.affiliation: Department of Neuroscience and Anesthesiology, University of Messina, Messina, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: David
authors.affiliation: Department of Paediatric Sciences, University of Messina, Messina, Italy.
authors.forename: Teresa
authors.initials: T
authors.lastname: Arrigo
authors.affiliation: Department of Paediatric Sciences, University of Messina, Messina, Italy.
authors.forename: Carmelo
authors.initials: C
authors.lastname: Salpietro
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D005260:Female; D024243:HMGB1 Protein / Q000097:blood*; D006801:Humans; D007239:Infections / Q000097:blood* / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D011379:Prognosis; D012307:Risk Factors; D013156:Splenectomy; D017086:beta-Thalassemia / Q000097:blood* / Q000175:diagnosis / Q000601:surgery
chemical_list: D015415:Biomarkers; D024243:HMGB1 Protein; C585491:HMGB1 protein, human
keywords: HMGB1; hepatitis C virus infection; infection; iron overload; splenectomy; thalassaemia