Abstract
Aims: To determine whether a correlation exists between paired cerebrospinal fluid (CSF) and serum levels of a novel inflammatory biomarker, high-mobility group box 1 (HMGB1), in different neurological conditions.Methods: HMGB1 was measured in the serum and CSF of 46 neurological patients (18 idiopathic intracranial hypertension [IIH], 18 neurological infection/inflammation [NII] and 10 Rasmussen’s encephalitis [RE]).Results: Mean serum (± SD) HMGB1 levels were 1.43 ± 0.54, 25.28 ± 27.9 and 1.89 ± 1.49 ng/ml for the patients with IIH, NII and RE, respectively. Corresponding mean (± SD) CSF levels were 0.35 ± 0.22, 4.48 ± 6.56 and 2.24 ± 2.35 ng/ml. Both CSF and serum HMGB1 was elevated in NII. Elevated CSF HMGB1 was demonstrated in RE. There was no direct correlation between CSF and serum levels of HMGB1.Conclusion: Serum HMGB1 cannot be used as a surrogate measure for CSF levels. CSF HMGB1 was elevated in NII and RE, its role as a prognostic/stratification biomarker needs further study.
Highlights
High-mobility group box 1 (HMGB1) is a small, highly conserved ubiquitous protein that shuttles between the nucleus and cytoplasm
There was no significant correlation between the serum and cerebrospinal fluid (CSF) HMGB1 concentrations in any of the conditions examined (Figure 1)
We have identified for the first time, albeit in a small cohort, that CSF HMGB1 is elevated in patients with Rasmussen’s encephalitis (RE) when compared to intracranial hypertension (IIH) patients, who served as “controls”
Summary
High-mobility group box 1 (HMGB1) is a small, highly conserved ubiquitous protein that shuttles between the nucleus and cytoplasm. Several studies have shown that serum HMGB1 may be a sensitive and specific biomarker for patient stratification in a number of diseases, ranging from drug-induced liver injury (Antoine et al 2013) to acute coronary syndrome (Goldstein et al 2006, Cirillo et al 2009, Hashimoto et al 2012) to many types of cancer (Chen et al 2013, Fahmueller et al 2013, Tabata et al 2013a, 2013b) In neurological conditions such as meningitis (Tang et al 2008, Asano et al 2011, Hohne et al 2013), multiple sclerosis and neuromyelitis optica (Wang et al 2013, Uzawa et al 2013), cerebrospinal fluid (CSF) levels of HMGB1 may have prognostic value. Blood is less invasive to obtain and blood biomarkers would be advantageous for diagnosing neurological disease, determining response to treatment and for determining prognosis
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