High mobility group box 1 as a biomarker for lumbar disc herniation severity in chronic low back pain.

INTRODUCTION

Chronic low back pain (LBP) is a widespread condition that significantly affects daily life. High mobility group box 1 (HMGB1), a proinflammatory cytokine, may contribute to the pathophysiology of LBP, particularly in relation to nucleus pulposus herniation (NHP). This study aimed to examine the correlation between herniation severity and lumbosacral HMGB1 levels in chronic LBP patients.

METHODS

This analytical observational study with a cross-sectional design was conducted in 2023 at Anutapura General Hospital, Palu. A total of 64 chronic LBP patients participated. Serum HMGB1 levels were measured, and magnetic resonance imaging was used to assess herniation severity. Pain severity was evaluated using the Numeric Pain Rating Scale (NPRS).

RESULTS

The mean HMGB1 level was 4701 (±1001.88). LBP onset was most common between 4 and 12 months (mean duration: 11.52 ± 5.54 months), with pain more frequently located on the right side (59%). Grade 3 herniation occurred most often (59%), and moderate pain (NPRS score 6) was the most common. HMGB1 levels peaked in Grade 2 herniation (5939.10 ± 873.26). NPRS scores increased with herniation severity, but weak correlations were found between NHP and HMGB1 ( = 0.174) and between HMGB1 and NPRS ( = 0.114).

CONCLUSIONS

No strong relationship was found between NHP and HMGB1 levels in chronic LBP patients. Further studies are needed to clarify HMGB1's role in LBP pathophysiology and its potential as a biomarker for disease severity or treatment response.