title: Prognostic value of HMGB1 and oxidative stress markers in multiple trauma patients: A single-centre prospective study.
abstract: Serious multiple traumatic injuries may rapidly become fatal or be complicated by a life-threatening sequelae leading to a significant increase of the mortality rate. Trauma scoring systems are used to evaluate the critical status of the patient and recently many different biomarkers have been taken into account to better estimate the potential clinical outcome. The aim of the present study is to analyse the expression pattern of high-mobility group box-1 (HMGB1), oxidative stress markers and nuclear factor erythroid 2-related (Nrf2) in critically ill traumatic patients (at hospital admittance and after 6 and 24 h), in order to find out their potential role as early post-traumatic predictors markers. Forty-seven patients admitted for multiple trauma and 15 healthy participants were prospectively recruited. Eight patients (17%) died within 92 h of admission; this subgroup of patients presented the highest severity scores and their HMGB1 expression levels were significantly correlated with ISS, whereas patients with higher ISS exhibited higher levels of HMGB1 (P <0.001). Our study suggests the role of HMGB1 as a predictive biomarker of outcome in injured patients and hypothesizes the protective role of Nrf2 in bringing down the oxidative stress and HMGB1 release; measuring HMGB1 in combination with Nrf2 might represent a potentially useful tool in the early detection of post-trauma complications.
authors.affiliation: Department of Biomedical and Dental Sciences and of Morphological and Functional Images, University Hospital of Messina, Messina, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Polito
authors.affiliation: Department of Human Pathology, University Hospital of Messina, Messina, Italy acromarco@yahoo.it.
authors.forename: Marco
authors.initials: M
authors.lastname: Cicciu'
authors.affiliation: Department of Clinical and Experimental Medicine, University Hospital of Messina, Messina, Italy.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Aguennouz
authors.affiliation: Department of Clinical and Experimental Medicine, University Hospital of Messina, Messina, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Cucinotta
authors.affiliation: Department of Drug Sciences and Health Products, University of Messina, Messina, Italy.
authors.forename: Mariateresa
authors.initials: M
authors.lastname: Cristani
authors.affiliation: Department of Biomedical and Dental Sciences and of Morphological and Functional Images, University Hospital of Messina, Messina, Italy.
authors.forename: Floriana
authors.initials: F
authors.lastname: Lauritano
authors.affiliation: Department of Biomedical and Dental Sciences and of Morphological and Functional Images, University Hospital of Messina, Messina, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Sindoni
authors.affiliation: Department of Human Pathology, University Hospital of Messina, Messina, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Gioffre'-Florio
authors.affiliation: Department of Human Pathology, University Hospital of Messina, Messina, Italy.
authors.forename: Fausto
authors.initials: F
authors.lastname: Fama
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000378:metabolism*; D005260:Female; D024243:HMGB1 Protein / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000378:metabolism* / Q000473:pathology*; D051267:NF-E2-Related Factor 2 / Q000378:metabolism; D018384:Oxidative Stress / Q000502:physiology*; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D015415:Biomarkers; D024243:HMGB1 Protein; C585491:HMGB1 protein, human; D051267:NF-E2-Related Factor 2; C495635:NFE2L2 protein, human
keywords: Injury Severity Score; high-mobility group box-1 (HMGB1); multiple trauma; nuclear factor erythroid 2-related (Nrf2); outcome; oxidative stress markers