Abstract
BackgroundHigh mobility group box 1 (HMGB1) is a late mediator of systemic inflammation. Extracellular HMGB1 play a central pathogenic role in critical illness. The purpose of the study was to investigate the association between plasma HMGB1 concentrations and the risk of poor outcomes in patients with severe blunt chest trauma.MethodsThe plasma concentrations of HMGB1 in patients with severe blunt chest trauma (AIS ≥ 3) were measured by a quantitative enzyme-linked immunosorbent assay at four time points during seven days after admission, and the dynamic release patterns were monitored. The biomarker levels were compared between patients with sepsis and non-sepsis, and between patients with multiple organ dysfunction syndrome (MODS) and non-MODS. The related factors of prognosis were analyzed by using multivariate logistic regression analysis. The short-form 36 was used to evaluate the quality of life of patients at 12 months after injury.ResultsPlasma HMGB1 levels were significantly higher both in sepsis and MODS group on post-trauma day 3, 5, and 7 compared with the non-sepsis and non-MODS groups, respectively. Multivariate analysis showed that HMGB1 levels and ISS were independent risk factors for sepsis and MODS in patients with severe blunt chest trauma.ConclusionsPlasma HMGB1 levels were significantly elevated in patients with severe blunt chest trauma. HMGB1 levels were associated with the risk of poor outcome in patients with severe blunt chest trauma. Daily HMGB1 levels measurements is a potential useful tool in the early identification of post-trauma complications. Further studies are needed to determine whether HMGB1 intervention could prevent the development of sepsis and MODS in patients with severe blunt chest trauma.
Highlights
High mobility group box 1 (HMGB1) is a late mediator of systemic inflammation
It has been demonstrated that HMGB1 plays a key pathogenic role in the pathogenesis of sepsis and multiple organ dysfunction syndrome (MODS) in critical illness including major trauma [4,5,6,7,8]
The results showed that the HMGB1 level and injury severity score (ISS) were independent risk factors for the development of sepsis [1.89; 2.23] and MODS of chest trauma patients [1.78
Summary
High mobility group box 1 (HMGB1) is a late mediator of systemic inflammation. A number of inflammatory cytokines, such as interleukin (IL)-1, IL-6, and IL-8, tumor necrotizing factor (TNF-α), which are involved in systemic inflammation caused by trauma, infection, cancer, chronic disease, and surgery [3], have been assessed for their roles as potential markers of the severity of inflammatory response. High mobility group box protein 1 (HMGB1) discovered originally as a nonhistone nuclear deoxyribonucleic acids binding protein has been identified as an important late mediator of systemic inflammation in contrast to other inflammatory cytokines mentioned. It has been demonstrated that HMGB1 plays a key pathogenic role in the pathogenesis of sepsis and multiple organ dysfunction syndrome (MODS) in critical illness including major trauma [4,5,6,7,8]. HMGB1 is an interesting candidate marker for monitoring patients with severe chest blunt trauma
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