title: HMGB1 level in cerebrospinal fluid as a complimentary biomarker for the diagnosis of tuberculous meningitis.
abstract: OBJECTIVE
  High mobility group box-1 (HMGB1) is a proinflammatory, DAMP protein that participates in many pathological conditions. In this study, we evaluated the usability of CSF HMGB1 as a biomarker for the diagnosis of tuberculous meningitis (TBM).
  
  
  METHODS
  A total of 59 TBM patients and 169 control patients were included in our study. CSF samples were obtained and analyzed for HMGB1 using a commercial ELISA kit.
  
  
  RESULTS
  The mean CSF HMGB1 was 19.36 ng/ml in TBM patients (n = 59) versus 3.12 ng/ml in non-TB meningitis patients (n = 30), 2.13 ng/ml in patients with extra neural tuberculosis (n = 73), and 1.06 ng/m in controls (n = 66). According to the receiver operator characteristic curves, a cut-off value of 3.4 ng/ml was calculated, indicating that the sensitivity and specificity of CSF HMGB1 alone in diagnosis of TBM were 61.02 and 89.94 %, respectively. In patients with extra neural tuberculosis and a high risk of TBM, CSF HMGB1 seemed to be a good candidate for early differential diagnosis of TBM at the cut-off value of 3.8 ng/ml, when the sensitivity and specificity were 79.49 and 94.52 % respectively.
  
  
  CONCLUSIONS
  Our finding may prove to be clinically useful, because CSF HMGB1 ELISA can be performed in almost all clinical laboratories, especially when sophisticated technologies are either time consuming or unavailable.
authors: Department of Clinical Laboratory Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, 200072 People's Republic of China.|Department of Laboratory Diagnosis, Changhai Hospital, the Second Military Medical University, Shanghai, 200433 People's Republic of China.
authors: Yan
authors: Y
authors: Chen
authors: Department of Clinical Laboratory Medicine, Shanghai Pulmonary Hospital, Tongji University, Shanghai, 200433 People's Republic of China.
authors: Jun
authors: J
authors: Zhang
authors: Department of Clinical Laboratory Medicine, Shanghai Pulmonary Hospital, Tongji University, Shanghai, 200433 People's Republic of China.
authors: Xiaofei
authors: X
authors: Wang
authors: Department of Laboratory Diagnosis, Changhai Hospital, the Second Military Medical University, Shanghai, 200433 People's Republic of China.
authors: Yu
authors: Y
authors: Wu
authors: Department of Laboratory Diagnosis, Changhai Hospital, the Second Military Medical University, Shanghai, 200433 People's Republic of China.
authors: Li
authors: L
authors: Zhu
authors: Department of Laboratory Diagnosis, Changhai Hospital, the Second Military Medical University, Shanghai, 200433 People's Republic of China.
authors: Longkun
authors: L
authors: Lu
authors: Department of Laboratory Diagnosis, Changhai Hospital, the Second Military Medical University, Shanghai, 200433 People's Republic of China.
authors: Qian
authors: Q
authors: Shen
authors: Department of Laboratory Diagnosis, Changhai Hospital, the Second Military Medical University, Shanghai, 200433 People's Republic of China.
authors: Yanghua
authors: Y
authors: Qin
keywords: Biomarker; Cerebrospinal fluid; HMGB1; Tuberculous meningitis