Significant increase of serum high-mobility group box chromosomal protein 1 levels in patients with severe acute pancreatitis
Significant increase of serum high-mobility group box chromosomal protein 1 levels in patients with severe acute pancreatitis
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DOI：
10.1097/01.mpa.0000236741.15477.8b
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发表时间：
2006-11-01
期刊：
影响因子：
2.9
通讯作者：
Kuroda, Yoshikazu
中科院分区：
文献类型：
--
作者：
Yasuda, Takeo;Ueda, Takashi;Kuroda, Yoshikazu
目的：重症急性胰腺炎（SAP）早期全身炎症反应和晚期脓毒症导致的多器官功能衰竭是导致高死亡率的主要原因。高迁移率族蛋白1（HMGB 1）最近被确定为一种有效的促炎介质，并在各种病理条件下，如败血症增加。本研究的目的是探讨HMGB 1在SAP中的作用。方法：我们采用酶联免疫吸附法测定45例SAP患者入院时血清HMGB 1浓度。结果：SAP患者血清HMGB 1水平（5.4 ± 1.3ng/mL）显著高于健康对照组（1.7 ± 0.3ng/mL）;血清HMGB 1水平与日本严重程度评分和格拉斯哥评分呈显著正相关。血清HMGB 1水平与乳酸脱氢酶、C反应蛋白、总胆红素呈显著正相关。HMGB 1水平在临床过程中器官功能障碍和感染的患者中较高。死亡组HMGB 1水平高于存活组。结论：SAP患者血清HMGB 1水平明显升高，且与病情严重程度相关。这些结果表明，HMGB 1可能是SAP炎症和器官衰竭的关键介质。
Objective: Multiple organ failure because of systemic inflammatory response in the early phase and sepsis in the late phase is the main contributor to high mortality in severe acute pancreatitis (SAP). High-mobility group box chromosomal protein 1 (HMGB1) was recently identified as a potent proinflammatory mediator and increases in various pathological conditions such as sepsis. The aim of this study was to investigate contributions of HMGB1 in SAP.Methods: We measured serum HMGB1 concentrations by an enzyme-linked immunosorbent assay in 45 patients with SAP at the time of admission. Furthermore, relationship between their serum HMGB1 levels and clinical factors was analyzed.Results: The mean value of serum HMGB1 levels was significantly higher in patients with SAP (5.4 +/- 1.3 ng/mL) than that in healthy volunteers (1.7 +/- 0.3 ng/mL). Serum HMGB1 levels were significantly positively correlated with the Japanese severity score and Glasgow score. Serum HMGB1 levels were significantly positively correlated with lactate dehydrogenase, C-reactive protein, and total bilirubin. The HMGB1 levels were higher in patients with organ dysfunction and infection during the clinical course. The HMGB1 levels in nonsurvivors were higher than those in survivors. Serum HMGB1 levels gradually declined after the admission.Conclusions: Serum HMGB1 levels were significantly increased in patients with SAP and were correlated with disease severity. These results suggest that HMGB1 may act as a key mediator for inflammation and organ failure in SAP.