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. 2015:2015:696248.
doi: 10.1155/2015/696248. Epub 2015 Apr 6.

HMGB-1 as a novel predictor of disease severity and prognosis in patients with hemorrhagic fever with renal syndrome

Hong Du  1 , Jing Li  1 , Haitao Yu  1 , Jianqi Lian  1 , Ye Zhang  1 , Ying Zhang  1 , Xuefan Bai  1 , Pingzhong Wang  1
Affiliations

HMGB-1 as a novel predictor of disease severity and prognosis in patients with hemorrhagic fever with renal syndrome

Hong Du et al. Mediators Inflamm. 2015.

Abstract

Objective: To examine the predictive capacity of the high mobility group box protein-1 (HMGB-1) for disease severity and prognosis of hemorrhagic fever with renal syndrome (HFRS).

Methods: One hundred and five HFRS patients and 28 controls were studied. The concentrations of HMGB-1 in the blood were measured with a commercially available ELISA. The levels of white blood cells (WBC), platelets (PLT), hematocrit (HCT), albumin (ALB), blood urea nitrogen (BUN), serum creatinine (Scr), and uric acid (UA) were routinely tested in the same time frame.

Results: The levels of HMGB-1 increased with the severity of the disease (P < 0.001). HMGB-1 was positively correlated with WBC and BUN and negatively correlated with PLT, ALB, and UA (P < 0.001). HMGB-1 showed statistical significance for predicting prognosis (AUC = 0.800, P < 0.001). The sensitivity and specificity of HMGB-1, WBC, PLT, and ALB used in combination for predicting outcome were better than those of single analyses (AUC = 0.892, P < 0.001).

Conclusions: HMGB-1 can be considered a novel biomarker for severity and outcome in patients with HFRS. The use of HMGB-1, WBC, PLT, and ALB in combination to predict the outcome in patients with HFRS exhibited an acceptable level of diagnostic capability.

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Figures

Figure 1
Figure 1
Levels of HMGB-1 during the clinical course in patients with HFRS. The concentrations of HMGB-1 were presented as medians with IQR and were compared by the Nemenyi Rank test among the five groups ((a) and (b)). The concentrations of HMGB-1 were presented as medians with IQR and were compared by a Mann-Whitney U test for the acute stage and convalescent stage (c). ∗ P < 0.05; ∗∗ P < 0.001.
Figure 2
Figure 2
Correlation between HMGB-1 and WBC (a), ALB (b), PLT (c), and BUN (d) in patients with HFRS. HMGB-1, high mobility group box protein-1; WBC, white blood cells; PLT, platelets; ALB, albumin; BUN, blood urea nitrogen.
Figure 3
Figure 3
Use of HMGB-1, WBC, PLT, and ALB in combination to predict prognosis in patients with HFRS by ROC analysis. ROC, receiver operating characteristic; HMGB-1, high mobility group box protein-1; WBC, white blood cells; PLT, platelets; ALB, albumin.
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