Plasma concentrations and importance of high mobility group box protein in the prognosis of organ failure in patients with disseminated intravascular coagulation
Plasma concentrations and importance of high mobility group box protein in the prognosis of organ failure in patients with disseminated intravascular coagulation
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DOI：
10.1160/th05-05-0316
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发表时间：
2005-11-01
影响因子：
6.7
通讯作者：
Maruyama, I
中科院分区：
文献类型：
--
作者：
Hatada, T;Wada, H;Maruyama, I
高迁移率族盒染色体蛋白 I (HMGB I) 是一种核 DNA 结合蛋白，当坏死细胞、活化的巨噬细胞和树突状细胞释放到细胞外空间时，可充当促炎细胞因子。 HMGB I 作用于特定受体 RAGE（晚期糖基化终产物受体），并诱导长期炎症、器官衰竭、败血症和死亡。本研究的目的是确定血浆 HMGBI 浓度的诊断价值及其在弥散性血管内凝血 (DIC) 患者器官衰竭发展中的作用。测量疑似 DIC 患者的血浆 HMGB-I 水平，并确定其与 DIC、器官衰竭和临床结果的关系。该研究在三重大学医学院重症监护室进行，纳入了 201 名疑似 DIC 患者。正常受试者的血浆 HMGB I 低于检测限，但在感染性疾病（4.54 +/- 8.18 ng/ml，平均值 +/- SD）、恶性肿瘤（2.15 +/- 5.34 ng/ml）和创伤（6.47 +/- 13.13 ng/ml）患者中适度升高。这些患者的 DIC 与显着高的血浆 HMGB I (14.05 +/- 2.56 ng/ml) 相关。 HMGBI 水平最高的是器官衰竭患者 (8.29 +/- 10.99 ng/ml) 和非幸存者 (16.58 +/- 11.01 ng/ml)。 HMGBI 血浆水平与 DIC 评分和脓毒症相关器官衰竭评估 (SOFA) 评分相关。总之，我们的数据表明 HMGB-I 是 OF 或 DIC 的潜在合适的预后标志物。
High Mobility Group Box chromosomal protein I (HMGB I) is a nuclear DNA-binding protein acting as a proinflammatory cytokine when released in the extracellular space from necrotic cells,activated macrophages and dendritic cells. HMGB I acts on a specific receptor, RAGE (receptor for advanced glycation end-products), and induces prolonged inflammation, organ failure, septicaemia and death. The aim of the study was to determine the diagnostic value of plasma HMGBI concentration and its role in the development of organ failure in patients with disseminated intravascular coagulation (DIC). Plasma HMGB-I levels were measured in patients with suspected DIC and their relationships with DIC, organ failure and clinical outcome were determined. The study took place at the intensive care facility, Mie University School of Medicine and comprised 201 patients with suspected DIC. Plasma HMGB I was below the detection limit in normal subjects, but moderately elevated in patients with infectious diseases (4.54 +/- 8.18 ng/ml, mean +/- SD), malignancies (2.15 +/- 5.34 ng/ml),and traumas (6.47 +/- 13.13 ng/ml). DIC was associated with significantly high plasma HMGB I (14.05 +/- 2.56 ng/ml) in these patients. The highest HMGBI levels were in patients with organ failure (8.29 +/- 10.99 ng/ml) and non-survivors (16.58 +/- 11.01 ng/ml). HMGBI plasma levels correlated with the DIC score and sepsis-related organ failure assessment (SOFA) score. In conclusion, our data suggest that HMGB-I is a potentially suitable prognostic marker of OF or DIC.