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. 2014 Dec 17:9:61.
doi: 10.1186/1749-7922-9-61. eCollection 2014.

Increased of serum high-mobility group box chromosomal protein 1 correlated with intestinal mucosal barrier injury in patients with severe acute pancreatitis

Gui-Fang Xu  1 , Ming Guo  2 , Zhi-Qiang Tian  3 , Guo-Zhong Wu  3 , Xiao-Ping Zou  1 , Wei-Jie Zhang  4
Affiliations

Increased of serum high-mobility group box chromosomal protein 1 correlated with intestinal mucosal barrier injury in patients with severe acute pancreatitis

Gui-Fang Xu et al. World J Emerg Surg. .

Abstract

Background: Secondary infections are the leading cause of death in patients with severe acute pancreatitis (SAP). The gut represents the main source of pancreatic contamination and related septic complications. High-mobility group box chromosomal protein 1 (HMGB1) was recently identified to play an important role in the SAP intestinal mucosal barrier dysfunction.

Objective: To investigate the correlation of high-mobility group box 1 (HMGB1) with intestinal barrier injury and infections in patients with severe acute pancreatitis (SAP).

Methods: The serum levels of HMGB1, amylase, lipase, and biochemical indicators were measured in 80 patients with SAP at the time of admission. Furthermore, relationship between their serum HMGB1 levels and intestinal barrier injury, infection and other clinical factors were analyzed.

Results: The mean value of serum HMGB1 levels was significantly higher in patients with SAP (6.02 ± 2.42 ng/mL) than that in healthy volunteers (1.87 ± 0.63 ng/mL). Serum HMGB1 levels were significantly positively correlated with the Ranson score. The HMGB1 levels were higher in patients with infection during the clinical course, the HMGB1 levels in non-survivors were higher than those in survivors, and positively correlated with DAO activity, L/M ratio, the concentration of endotoxin (R = 0.484, P <0.01).

Conclusions: HMGBl level of patients with severe acute pancreatitis was significantly increased, and can be used as an important indicator to determine the intestinal barrier dysfunction and infection.

Keywords: High-mobility group box chromosomal protein 1 (HMGB1); Infection; Inflammation; Injury; Intestinal mucosal barrier; Severe acute pancreatitis.

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Figures

Figure 1
Figure 1
Correlation of serum high-mobility group box chromosomal protein 1 levels with blood biochemical parameters on admission in patients with severe acute pancreatitis.
Figure 2
Figure 2
A, Correlation of serum HMGB1 levels with Ranson scores on admission. B, A comparison between serum levels of HMGB1 in high (>3) and low (<3) Ranson score groups.
Figure 3
Figure 3
Correlation efficient of serum HMGB1 levels with intestinal mucosal barrier parameters (plasma DAO activity, serum endotoxin, urinary L/M ratio).
Figure 4
Figure 4
Relationship of serum HMGB1 levels with infection and prognosis. Infection was defined as described under Materials and Methods.
See this image and copyright information in PMC

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