Changes in serum high mobility group box-1 protein and high-sensitivity C-reactive protein in patients with acute cerebral infarction and their clinical significance

Abstract

To study the potential role of high mobility group box-1 protein (HMGB1) and high-sensitivity C-reactive protein (hs-CRP) in acute cerebral infarction (ACI). Forty patients with ACI were enrolled within 72 hours after onset of symptom in this study. Venous blood samples were collected within 24 hours of admission, 7th day and 12th day after admission. Serum HMGB1 and hs-CRP levels were measured with enzyme linked immunosorbent assay (ELISA) method. Serum HMGB1 levels (μg/L) at all time points (24 hours: 7.598±0.280, 7th day: 10.491±0.512, 12th day: 5.315±0.224) were significantly higher than those of healthy controls (n=20, 2.994±0.243) and risk factor group in which patients suffered from one risk factor in hypertension, diabetes mellitus, and hyperlipemia at least (n=20, 3.272±0.285), with significant difference (all P<0.01). Serum hs-CRP levels (mg/L, 24 hours: 5.815±0.408, 7th day: 5.063±0.510, 12th day: 2.863±0.297) of the patients were also significantly higher than those of healthy controls (0.642±0.047), with significant difference (all P<0.01), and serum hs-CRP levels on 12th day were similar to that in risk factor group (2.514±0.312), with no significant difference (P>0.05). Serum HMGB1 levels in risk factor group were higher than those in healthy control group but with no significant difference (P>0.05), and serum hs-CRP levels were significantly higher than those in healthy control group (P<0.01). The levels of HMGB1 and hs-CRP in serum were similar between patients with cerebral infarction in vertebral basilar system (n=17) and internal carotid artery system (n=23), and the result showed that the serum HMGB1 or hs-CRP levels had no correlation with infarct site, but had significantly positive correlations with the National Institute of Health stroke scale (NIHSS) score [r1=0.377, P1=0.034; r2=0.353, P2=0.025]. In addition, there was a positive correlation between levels of serum HMGB1 and hs-CRP (r=0.428, P=0.047). CONCLUSIONS; Inflammatory mediators including HMGB1 and hs-CRP might play important roles in the pathogenesis of ACI. They were positively correlated with the severity of ACI, while not correlated with infarct sites. Serum hs-CRP levels in ACI could be of value in early diagnosing of cerebral infarction. Serial determination of serum HMGB1 and hs-CRP levels might be helpful to evaluate the severity and prognosis of ACI.