High Mobility Group Box Protein Is Increased in the Plasma and May Have a Role in Development of Organ Failure in DIC

Abstract number: OR032

Hideo¹ W, Yamada² S, Kobayashi¹ T, Hiroshi¹ Shiku, Abe¹ Y, Nishioka¹ J, Nobori¹ N, Maruyama³ I

¹¹Mie University School of Medicine, Tsu, Japan ¹¹Mie University School of Medicine, Tsu, Japan ²²Central Institue, Shino-Test Co, Sagamihara, Japan ³³Kagoshima University Graduate School and Dental Science, Kagoshima, Japan

High Mobility Group Box chromosomal protein 1 (HMGB1), a nuclear DNA-binding protein, was recently re-discovered as a new proinflammatory cytokine when released in the extracellular space from necrotic cells and activated macrophages or dendritic cells. The protein acts on the specific receptor, RAGE (receptor for advanced glycation endproducts), and induces the prolonged inflammation, organ failures, and resultant lethality in septicemia. Here, we measured HMGB1 in the plasma from disseminated intravascular coagulation (DIC)-patients, and evaluated the diagnostic value of plasma concentration of HMGB1 in development into organ failure among these patients. HMBG-1 was measured by ELISA. Normal plasma did not contain HMGB1, however it was moderately elevated in the plasma from the patients with various infectious diseases (3.76 ± 8.43 ng/ml), malignancies (6.47 ± 13.13 ng/ml), and traumas (4.62 ± 11.25 ng/ml). Complication of DIC significantly raised plasma HMGB1 (14.05 ± 12.56 ng/ml) level among these patients. Moreover it showed the highest values in patients with organ failures (8.29 ± 10.99 ng/ml) and non-survivors (16.58 ± 11.01 ng/ml). Plasma levels of HMGB1 were well correlated with DIC score and sepsis related organ failure assessment (SOFA) score. Thus it was suggested that HMGB1 will be a novel marker of organ failure with prognostic value.