Plasma concentrations and importance of high mobility group box protein in the prognosis of organ failure in patients with disseminated intravascular coagulation

Tsuyoshi Hatada; Hideo Wada; Tsutomu Nobori; Kazuhiro Okabayashi; Kazuo Maruyama; Yasunori Abe; Shinji Uemoto; Shingo Yamada; Ikuro Maruyama

doi:10.1160/TH05-05-0316

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2005; 94(05): 975-979
DOI: 10.1160/TH05-05-0316

Blood Coagulation, Fibrinolysis and Cellular Haemostasis

Schattauer GmbH

Plasma concentrations and importance of high mobility group box protein in the prognosis of organ failure in patients with disseminated intravascular coagulation

Authors

Tsuyoshi Hatada

¹Department of Emergency Medicine, Mie University School of Medicine, Mie, Japan
Hideo Wada

²Department of Laboratory Medicine, Mie University School of Medicine, Mie, Japan
Tsutomu Nobori

²Department of Laboratory Medicine, Mie University School of Medicine, Mie, Japan
Kazuhiro Okabayashi

³Department of Anesthesiology, Mie University School of Medicine, Mie, Japan
Kazuo Maruyama

³Department of Anesthesiology, Mie University School of Medicine, Mie, Japan
Yasunori Abe

⁴Department of Central Laboratory, Mie University School of Medicine, Mie, Japan
Shinji Uemoto

⁵First Department of Surgery, Mie University School of Medicine, Mie, Japan
Shingo Yamada

⁶Central Institute, Shino-Test Co., Tokyo, Japan
Ikuro Maruyama

⁷Vascular medicine, Kagoshima University Graduate School and Dental Science, Kagoshima, Japan

Abstract

Summary

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 endproducts), 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 HMGBI 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.

Keywords

HMGB-1 - DIC - organ failure

Full Text

References

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