title: High mobility group box 1 and tumor growth factor β: useful biomarkers in pediatric patients receiving peritoneal dialysis.
abstract: BACKGROUND
  Peritonitis, the most important limitation of peritoneal dialysis (PD), could be detected by biomarkers in dialysate effluent, representing a noninvasive method to indirectly assess the peritoneum status. The aim of our study was to test high mobility group box 1 (HMGB1) in PD patients, evaluating its role as precocious marker of peritoneum damage during peritonitis. Transforming growth factor (TGF)-β was correlated with peritoneal transport characteristics.
  
  
  METHODS
  Six patients, treated by ambulatory PD, were enrolled. Samples were collected at the onset of peritonitis (T1) and every day until its resolution (T-end). Serum (s) and peritoneal (p) white blood cell (WBC) count was also evaluated. Peritoneal Equilibration Test evaluated the filter activity of peritoneum.
  
  
  RESULTS
  In patients with acute peritonitis, the highest serum and peritoneal HMGB1 values (64 ± 3.6 and 70 ± 5.3 ng/mL, respectively) were assessed, with a progressive decrease of their levels at the resolution time (T-end: sHMGB1:36 ± 2.5; pHMGB1:30.5 ± 7.0 ng/mL). While no differences of sWBC and pWBC were observed between baseline and T-end values, pHMGB1 levels remained higher at T-end than those observed at T0 (pHMGB1:30.5 ± 7.0 versus 6.9 ± 3.6; p < 0.0001). TGF-β levels were higher in patients with low peritoneal permeability than in medium or high transporter patients (81 ± 15.5 versus 24.3 ± 7.5 pg/mL; p = 0.01). An inverse correlation was found between TGF-β levels and dialysate/plasmatic creatinine values (r = -0.83; p = 0.03).
  
  
  CONCLUSIONS
  HMGB1 represents a useful biomarker for peritoneum evaluation in PD patients. A prognostic role of this alarmin, as a marker of response to therapy, could be hypothesized. TGF-β could predict the peritoneal transport status and dialysis technique adequacy.
authors: a Department of Pediatric Sciences, Unit of Pediatric Nephrology and Rheumatology , University of Messina , Messina , Italy.
authors: Roberto
authors: R
authors: Chimenz
authors: b Department of Clinical and Experimental Medicine, Division of Nephrology and Dialysis , University of Messina , Messina , Italy.
authors: Antonio
authors: A
authors: Lacquaniti
authors: a Department of Pediatric Sciences, Unit of Pediatric Nephrology and Rheumatology , University of Messina , Messina , Italy.
authors: Laura
authors: L
authors: Colavita
authors: a Department of Pediatric Sciences, Unit of Pediatric Nephrology and Rheumatology , University of Messina , Messina , Italy.
authors: Valeria
authors: V
authors: Chirico
authors: a Department of Pediatric Sciences, Unit of Pediatric Nephrology and Rheumatology , University of Messina , Messina , Italy.
authors: Claudia
authors: C
authors: Fede
authors: b Department of Clinical and Experimental Medicine, Division of Nephrology and Dialysis , University of Messina , Messina , Italy.
authors: Michele
authors: M
authors: Buemi
authors: a Department of Pediatric Sciences, Unit of Pediatric Nephrology and Rheumatology , University of Messina , Messina , Italy.
authors: Carmelo
authors: C
authors: Fede
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D024243:HMGB1 Protein / Q000097:blood*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000378:metabolism / Q000628:therapy*; D008297:Male; D010530:Peritoneal Dialysis; D010538:Peritonitis / Q000097:blood / Q000209:etiology*; D011379:Prognosis; D016212:Transforming Growth Factor beta / Q000097:blood*
chemical_list: D015415:Biomarkers; D024243:HMGB1 Protein; D016212:Transforming Growth Factor beta
keywords: HMGB1; TGF-β; pediatric nephrology; peritoneal biomarkers; peritoneal dialysis adequacy; peritonitis