Hatada Tsuyoshi, Wada Hideo, Nobori Tsutomu, Okabayashi Kazuhiro, Maruyama Kazuo, Abe Yasunori, Uemoto Shinji, Yamada Shingo, Maruyama Ikuro
Department of Emergency Medicine, Mie University School of Medicine, Mie, Japan.
Thromb Haemost. 2005 Nov;94(5):975-9. doi: 10.1160/TH05-05-0316.
High Mobility Group Box chromosomal protein 1 (HMGB1) is a nuclear DNA-binding protein acting as a proinflammatory cytokine when released in the extracellular space from necrotic cells,activated macrophages and dendritic cells. HMGB1 acts on a specific receptor, RAGE (receptor for advanced glycation end-products), and induces prolonged inflammation, organ failure, septicaemia and death. The aim of the study was to determine the diagnostic value of plasma HMGB1 concentration and its role in the development of organ failure in patients with disseminated intravascular coagulation (DIC). Plasma HMGB-1 levels were measured in patients with suspected DIC and their relationships with DIC, organ failure and clinical outcome were determined. The study took place at the intensive care facility, Mie University School of Medicine and comprised 201 patients with suspected DIC. Plasma HMGB1 was below the detection limit in normal subjects, but moderately elevated in patients with infectious diseases (4.54 +/- 8.18 ng/ml, mean +/- SD), malignancies (2.15 +/- 5.34 ng/ml),and traumas (6.47 +/- 13.13 ng/ml). DIC was associated with significantly high plasma HMGB1 (14.05 +/- 12.56 ng/ml) in these patients. The highest HMGB1 levels were in patients with organ failure (8.29 +/- 10.99 ng/ml) and non-survivors (16.58 +/- 11.01 ng/ml). HMGB1 plasma levels correlated with the DIC score and sepsis-related organ failure assessment (SOFA) score. In conclusion, our data suggest that HMGB-1 is a potentially suitable prognostic marker of OF or DIC.
高迁移率族蛋白B1（HMGB1）是一种核DNA结合蛋白，当它从坏死细胞、活化的巨噬细胞和树突状细胞释放到细胞外空间时，可作为一种促炎细胞因子发挥作用。HMGB1作用于特定受体——晚期糖基化终产物受体（RAGE），并诱导持续性炎症、器官衰竭、败血症和死亡。本研究的目的是确定血浆HMGB1浓度的诊断价值及其在弥散性血管内凝血（DIC）患者器官衰竭发生中的作用。测定了疑似DIC患者的血浆HMGB-1水平，并确定了其与DIC、器官衰竭和临床结局的关系。该研究在三重大学医学院重症监护病房进行，纳入了201例疑似DIC患者。正常受试者血浆HMGB1低于检测限，但在传染病患者（4.54±8.18 ng/ml，平均值±标准差）、恶性肿瘤患者（2.15±5.34 ng/ml）和创伤患者（6.47±13.13 ng/ml）中中度升高。在这些患者中，DIC与血浆HMGB1显著升高（14.05±12.56 ng/ml）相关。器官衰竭患者（8.29±10.99 ng/ml）和非幸存者（16.58±11.01 ng/ml）的HMGB1水平最高。血浆HMGB1水平与DIC评分和脓毒症相关器官衰竭评估（SOFA）评分相关。总之，我们的数据表明，HMGB-1可能是器官衰竭或DIC的合适预后标志物。
