Role of plasma high mobility group box-1 in disseminated intravascular coagulation with leukemia
Role of plasma high mobility group box-1 in disseminated intravascular coagulation with leukemia
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血浆高迁移率族蛋白box-1在白血病弥漫性血管内凝血中的作用
DOI：
10.1016/j.thromres.2015.05.030
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发表时间：
2015-08-01
影响因子：
7.5
通讯作者：
Hu, Yu
中科院分区：
文献类型：
--
作者：
Wang, Manzhi;Mei, Heng;Hu, Yu
简介：高迁移率族蛋白1（HMGB 1）是一种DNA结合蛋白，当由坏死细胞、单核细胞或巨噬细胞释放时，可作为促炎细胞因子发挥作用。它还在凝血激活和包括白血病在内的几种肿瘤中发挥作用。本研究旨在探讨高迁移率族蛋白1（HMGB 1）在白血病DIC诊断中的作用。其中83例疑似DIC，6例为阴性对照。分别收集或测定其临床资料、实验室检查和血浆标本。结果：DIC组血浆HMGB 1水平高于非DIC组（115.16 ng/ml vs. 63.94 ng/ml，p = 0.003）。感染组和非感染组的结果相似。沿着DIC评分的增加，HMGB 1水平逐渐升高（p = 0.006）。HMGB 1是诊断白血病合并DIC的独立因素（p < 0.05）。HMGB 1诊断DIC的敏感性为90.32%，且在DIC前患者中有升高的趋势。这6例DIC前患者中有3例通过新修订的包含HMGB 1的评分系统诊断为DIC。SOFA = 2的白血病患者血浆HMGB 1水平显著高于无SOFA的患者（118.76 vs.72.75，p = 0.032）。结论：白血病患者血浆HMGB 1水平升高与DIC的诊断及严重程度密切相关。此外，HMGB 1的诊断敏感性高。因此，血浆HMGB 1是一个有价值的分子标志物，可作为白血病DIC早期诊断的辅助指标。(C)2015爱思唯尔有限公司版权所有。
Introduction: High mobility group box 1(HMGB1) is a DNA-binding protein which can act as a proinflammatory cytokine when released by necrotic cells, monocytes or macrophages. It also plays a role in the coagulation activation and several tumors including leukemia. The objective of this study was to investigate the role of HMGB1 in the diagnosis of DIC with leukemia.Methods: 89 subjects with leukemia in Wuhan Union Hospital were prospectively recruited. Among them, 83 cases were suspected of DIC, while the other 6 were the negative controls. Their clinical data, laboratory tests and plasma samples were collected or measured respectively. Accordingly, we made scores for these subjects by the Japanese Ministry of Health and Welfare (JMHW) criteria.Results: This study demonstrated that the plasma levels of HMGB1 were higher in the DIC group than non-DIC (115.16 ng/ml vs. 63.94 ng/ml, p = 0.003). The similar results were achieved in infected or non-infected groups. And along with the increase of DIC scores, the levels of HMGB1 increased gradually (p = 0.006). In addition, HMGB1 was an independent factor in the diagnosis of DIC with leukemia(p < 0.05). The diagnostic sensitivity of HMGB1 was high (Se = 90.32%), and there was a tendency of increased HMGB1 levels in the pre-DIC patients. Three of these six pre-DIC patients were diagnosed as DIC by the new revised scoring system which contained HMGB1. Finally, the HMGB1 levels were significantly higher in patients with organ failures (SOFA = 2) than those without (118.76 vs. 72.75, p = 0.032).Conclusion: The increased plasma levels of HMGB1 were related tightly to the diagnosis and severity of DIC in leukemia patients. Furthermore, the diagnostic sensitivity of HMGB1 was high. So HMGB1 in plasma is a helpful molecular marker, and can be added in the scoring system for the early diagnosis of DIC with leukemia. (C) 2015 Elsevier Ltd. All rights reserved.