Diagnostic significance of serum levels of serum amyloid A,procalcitonin,and high-mobility group box 1 in identifying necrotising enterocolitis in newborns

BACKGROUND Necrotising enterocolitis(NEC)is a critical gastrointestinal emergency affecting premature and low-birth-weight neonates.Serum amyloid A(SAA),procalcitonin(PCT),and high-mobility group box 1(HMGB1)have emerged as potential biomarkers for NEC due to their roles in inflammatory response,tissue damage,and immune regulation.AIM To evaluate the diagnostic value of SAA,PCT,and HMGB1 in the context of NEC in newborns.METHODS The study retrospectively analysed the clinical data of 48 newborns diagnosed with NEC and 50 healthy newborns admitted to the hospital.Clinical,radiological,and laboratory findings,including serum SAA,PCT,and HMGB1 Levels,were collected,and specific detection methods were used.The diagnostic value of the biomarkers was evaluated through statistical analysis,which was performed using chi-square test,t-test,correlation analysis,and receiver operating characteristic(ROC)analysis.RESULTS The study demonstrated significantly elevated levels of serum SAA,PCT,and HMGB1 Levels in newborns diagnosed with NEC compared with healthy controls.The correlation analysis indicated strong positive correlations among serum SAA,PCT,and HMGB1 Levels and the presence of NEC.ROC analysis revealed promising sensitivity and specificity for serum SAA,PCT,and HMGB1 Levels as potential diagnostic markers.The combined model of the three biomarkers demonstrating an extremely high area under the curve(0.908).CONCLUSION The diagnostic value of serum SAA,PCT,and HMGB1 Levels in NEC was highlighted.These biomarkers potentially improve the early detection,risk stratification,and clinical management of critical conditions.The findings suggest that these biomarkers may aid in timely intervention and the enhancement of outcomes for neonates affected by NEC.

Hmo1:A versatile member of the high mobility group box family of chromosomal architecture proteins

Eukaryotic chromatin consisting of nucleosomes connected by linker DNA is organized into higher order structures,which is facilitated by linker histone H1.Formation of chromatin compacts and protects the genome,but also hinders DNA transactions.Cells have evolved mechanisms to modify/remodel chromatin resulting in chromatin states suitable for genome functions.The high mobility group box(HMGB)proteins are non-histone chromatin architectural factors characterized by one or more HMGB motifs that bind DNA in a sequence nonspecific fashion.They play a major role in chromatin dynamics.The Saccharomyces cerevisiae(yeast hereafter)HMGB protein Hmo1 contains two HMGB motifs.However,unlike a canonical HMGB protein that has an acidic C-terminus,Hmo1 ends with a lysine rich,basic,C-terminus,resembling linker histone H1.Hmo1 exhibits characteristics of both HMGB proteins and linker histones in its multiple functions.For instance,Hmo1 promotes transcription by RNA polymerases I and II like canonical HMGB proteins but makes chromatin more compact/stable like linker histones.Recent studies have demonstrated that Hmo1 destabilizes/disrupts nucleosome similarly as other HMGB proteins in vitro and acts to maintain a common topological architecture of genes in yeast genome.This minireview reviews the functions of Hmo1 and the underlying mechanisms,highlighting recent discoveries.

Suppressing high mobility group box-1 release alleviates morphine tolerance via the adenosine5'-monophosphate-activated protein kinase/heme oxygenase-1 pathway

Opioids,such as morphine,are the most potent drugs used to treat pain.Long-term use results in high tolerance to morphine.High mobility group box-1(HMGB1) has been shown to participate in neuropathic or inflammatory pain,but its role in morphine tolerance is unclear.In this study,we established rat and mouse models of morphine tolerance by intrathecal injection of morphine for 7 consecutive days.We found that morphine induced rat spinal cord neurons to release a large amount of HMGB1.HMGB1 regulated nuclear factor κB p65 phosphorylation and interleukin-1β production by increasing Toll-like receptor 4receptor expression in microglia,thereby inducing morphine tolerance.Glycyrrhizin,an HMGB1 inhibito r,markedly attenuated chronic morphine tole rance in the mouse model.Finally,compound C(adenosine 5’-monophosphate-activated protein kinase inhibitor) and zinc protoporphyrin(heme oxygenase-1 inhibitor)alleviated the morphine-induced release of HMGB1 and reduced nuclear factor κB p65 phosphorylation and interleukin-1β production in a mouse model of morphine tolerance and an SH-SY5Y cell model of morphine tole rance,and alleviated morphine tolerance in the mouse model.These findings suggest that morphine induces HMGB1 release via the adenosine 5’-monophosphate-activated protein kinase/heme oxygenase-1 signaling pathway,and that inhibiting this signaling pathway can effectively reduce morphine tole rance.

High-mobility group box 1 protein and its role in severe acute pancreatitis

The high mobility group box 1(HMGB1),which belongs to the subfamily of HMG-1/-2,is a highly conserved single peptide chain consisting of 215 amino acid residues with a molecular weight of approximately 24894 Da.HMGB1 is a ubiquitous nuclear protein in mammals and plays a vital role in inflammatory diseases.Acute pancreatitis is one of the most common causes of acute abdominal pain with a poor prognosis.Acute pancreatitis is an acute inflammatory process of the pancreas(duration of less than six months),for which the severe form is called severe acute pancreatitis(SAP).More and more studies have shown that HMGB1 has a bidirectional effect in the pathogenesis of SAP.Extracellular HMGB1 can aggravate the pancreatic inflammatory process,whereas intracellular HMGB1 has a protective effect against pancreatitis.The mechanism of HMGB1 is multiple,mainly through the nuclear factor-κB pathway.Receptors for advanced glycation endproducts and toll-like receptors(TLR),especially TLR-2 and TLR-4,are two major types of receptors mediating the inflammatory process triggered by HMGB1 and may be also the main mediators in the pathogenesis of SAP.HMGB1 inhibitors,such as ethyl pyruvate,pyrrolidine dithiocarbamate and Scolopendra subspinipes mutilans,can decrease the level of extracellular HMGB1 and are the promising targets in the treatment of SAP.

Scolopendra subspinipes mutilans protected the ceruleininduced acute pancreatitis by inhibiting high-mobility group box protein-1

AIM:To evaluate the inhibitory effects of Scolopendra subspinipes mutilans(SSM) on cerulein-induced acute pancreatitis(AP) in a mouse model.METHODS:SSM water extract(0.1,0.5,or 1 g/kg) was administrated intraperitoneally 1 h prior to the first injection of cerulein.Once AP developed,the stable cholecystokinin analogue,cerulein was injected hourly,over a 6 h period.Blood samples were taken 6 h later to determine serum amylase,lipase,and cytokine levels.The pancreas and lungs were rapidly removed for morphological examination,myeloperoxidase assay,and real-time reverse transcription polymerase chain reaction.To specify the role of SSM in pancreatitis,the pancreatic acinar cells were isolated using collagenase method.Then the cells were pre-treated with SSM,then stimulated with cerulein.The cell viability,cytokine productions and high-mobility group box protein-1(HMGB-1) were measured.Furthermore,the regulating mechanisms of SSM action were evaluated.RESULTS:The administration of SSM significantly attenuated the severity of pancreatitis and pancreatitis associated lung injury,as was shown by the reduction in pancreatic edema,neutrophil infiltration,vacuolization and necrosis.SSM treatment also reduced pancreatic weight/body weight ratio,serum amylase,lipase and cytokine levels,and mRNA expression of multiple inflammatory mediators such as tumor necrosis factor-α and interleukin-1β.In addition,treatment with SSM inhibited HMGB-1 expression in the pancreas during AP.In accordance with in vivo data,SSM inhibited the cerulein-induced acinar cell death,cytokine,and HMGB-1 release.SSM also inhibited the activation of c-Jun NH2-terminal kinase,p38 and nuclear factor(NF)-κB.CONCLUSION:These results suggest that SSM plays a protective role during the development of AP and pancreatitis associated lung injury via deactivating c-Jun NH2-terminal kinase,p38 and NF-κB.

Clinical signification of high-mobility group box 1protein(HMGB1) expression in infiltrating ductalcarcinoma breast tissue

Objective: Exploring the clinical signification of high-mobility group box 1 protein(HMGB1) expression in infiltrating ductal carcinoma(IDC) breast tissue. Methods: The expression of HMGB1 protein in IDC breast tissue was detected by immunohistochemistry, and the relations among size of tumour, lymph node metastasis, clinical staging, estrogen receptor(ER), progesterone receptor(PR) and human epidermal growth factor receptor 2(HER-2) were also analyzed. Results: Fortysix cases out of 60 cases of IDC breast tissue showed positive or strong positive HMGB1 expression(76.67%), statistical significance was observed between HMGB1 expression with clinical staging(P < 0.01), lymph node metastasis(P < 0.01), breast cancer ER(P < 0.05) and HER-2(P < 0.05), however same conclusion can not be drawn between HMGB1 with either size of tumour or PR expression(P > 0.05) in IDC breast tissue. Spearman analysis showed negative correlation between HMGB1 expression and ER, and positive correlation between HMGB1 expression and clinical staging, lymph node metastasis together with HER-2. Conclusion: It's promising that HMGB1 expression in IDC tissue can be one of biological indicators of poor prognosis.

高迁移率族蛋白B1、Toll样受体4表达与难治性癫痫患者临床特征的关系及其预测价值

目的探讨高迁移率族蛋白B1(HMGB1)、Toll样受体4(TLR4)表达与难治性癫痫患者临床特征相关性以及预测价值。方法回顾性分析84例难治性癫痫患者临床资料并将其纳入观察组。同期选择35例行颅内减压术的高颅内压患者作为对照组。采用免疫组织化学法检测HMGB1、TLR4表达情况,采用尼氏染色法观察组织形态,同时分析相关实验结果。结果观察组HMGB1和TLR4表达高于对照组,差异有统计学意义(P<0.05)。观察组HMGB1、TLR4蛋白条带的光密度值与内参β-actin条带光密度值高于对照组,差异有统计学意义(P<0.05)。TLR4表达强度与癫痫发作频率、发作持续时间、病程、发作类型有关,而HMGB1表达强度与癫痫发作频率、发作持续时间、病程有关。病灶组织中,TLR4表达与HMGB1的表达呈正相关,提示两者存在协同作用。受试者工作特征(ROC)曲线分析显示,TLR4蛋白、HMGB1蛋白预测难治性癫痫的曲线下面积(AUC)分别为0.888、0.923。结论HMGB1、TLR4在难治性癫痫患者病灶中呈高表达,且两者表达强度呈正相关,能够在一定程度上预测疾病发生、发展情况,为难治性癫痫的诊疗提供了新的生物标志物。

血清Ang-2和HMGB1水平与脓毒症患者病情及预后相关性的研究

目的 探究血清血管生成素-2(Ang-2)和高迁移率族蛋白B1(HMGB1)水平与脓毒症患者病情及28天预后的相关性。方法 回顾性分析41例脓毒症患者资料,根据患者28天的预后情况分为存活组和死亡组;根据患者病情严重程度将2组患者分别分为脓毒症组和脓毒性休克组。记录所有入组患者的一般资料并进行第1天、第3天、第5天及第7天的APACHEⅡ评分,测定Ang-2和HMGB1水平。结果 存活组与死亡组患者的一般资料比较差异无统计学意义。死亡组脓毒症休克患者占比及入科APACHEⅡ评分为(85.71%)和(29.29±5.99)分,均明显高于存活组(51.84%)和(24.96±5.84)分。2组患者血清Ang-2和HMGB1水平比较差异无统计学意义。第7天的HMGB1水平与脓毒症患者预后显著相关,而第1天、第3天、第5天的HMGB1水平及上述各时间点的Ang-2水平与患者预后均无相关性。各时间点血清Ang-2水平的算术平均值与APACHEⅡ评分的算术平均值呈正相关,HMGB1水平与APACHEⅡ评分并无相关性。联合第7天的APACHEⅡ评分、Ang-2和HMGB1水平的曲线下面积最大为0.78,灵敏度为92.9%,特异度为59.3%。联合第7天的Ang-2和HMGB1水平预测预后不良的曲线下面积为0.71,灵敏度为92.9%,特异度为55.6%。结论 脓毒症患者第1天、第3天、第5天及第7天的平均血清Ang-2水平与病情严重程度呈正相关;联合脓毒症患者第7天的血清Ang-2和HMGB1水平对其预后进行评估灵敏度最高,明显高于单独某项指标的评估价值。

High mobility group box-1 protein inhibits regulatory T cell immune activity in liver failure in patients with chronic hepatitis B

BACKGROUND: Liver failure in chronic hepatitis B (CHB) patients is a severe, life-threatening condition. Intestinal endotoxemia plays a significant role in the progress to liver failure. High mobility group box-1 (HMGB1) protein is involved in the process of endotoxemia. Regulatory T (Treg) cells maintain immune tolerance and contribute to the immunological hyporesponsiveness against HBV infection. However, the roles of HMGB1 and Treg cells in the pathogenesis of liver failure in CHB patients, and whether HMGB1 affects the immune activity of Treg cells are poorly known at present, and so were explored in this study. METHODS: The levels of HMGB1 expression were detected by ELISA, real-time RT-PCR, and Western blotting, and the percentage of CD4(+)CD25(+)CD127(low) Treg cells among CD4(+) cells was detected by flow cytometry in liver failure patients with chronic HBV infection, CHB patients, and healthy controls. Then, CD4(+)CD25(+)CD127(low) Treg cells isolated from the peripheral blood mononuclear cells from CHB patients were stimulated with HMGB1 at different concentrations or at various intervals. The effect of HMGB1 on the immune activity of Treg cells was assessed by a suppression assay of the allogeneic mixed lymphocyte response. The levels of forkhead box P3 (Foxp3) expression in Treg cells treated with HMGB1 were detected by RT-PCR and Western blotting. RESULTS: A higher level of HMGB1 expression and a lower percentage of Treg cells within the population of CIA(+) cells were found in liver failure patients than in CHB patients (82.6+/-20.1 mu g/L vs. 34.2+/-13.7 mu g/L; 4.55+/-1.34% vs. 9.52+/-3.89%, respectively). The immune activity of Treg cells was significantly weakened and the levels of Foxp3 expression were reduced in a dose- or time-dependent manner when Treg cells were stimulated with HMGB1 in vitro. CONCLUSIONS: The high level of HMGB1 and the low percentage of Treg cells play an important role in the pathogenesis of liver failure in patients with chronic HBV infection. Moreover, HMGB1 can weaken the immune activity of Treg cells. It is suggested that effectively inhibiting HMGB1 expression could be a feasible way to treat liver failure by suppressing endotoxemia and enhancing Treg cell activity.

Inhibition of high-mobility group box 1 expression by siRNA in rat hepatic stellate cells

AIM:To explore the role of high-mobility group box 1 (HMGB1) protein during liver fibrogenesis and investigate the functional effects of HMGB1 gene silencing in hepatic stellate cells (HSCs) using siRNA.METHODS:Hepatic fibrosis in rats was induced through serial subcutaneous injections of dimethylnitrosamine,and expression of HMGB1 was detected by immunohistochemistry.HMGB1 siRNAs were developed and transiently transfected into HSC-T6 cells using Lipofectamine 2000.HMGB1 expression was evaluated by real-time polymerase chain reaction (PCR) and Western blotting analysis.Expression of α-smooth muscle actin (α-SMA) and collagen typesⅠand Ⅲ was evaluated by real-time PCR.Cell proliferation and the cell cycle were determined using the methyl thiazolyl tetrazolium method.Finally,collagen content in HSC supernatant was evaluated by an enzyme-linked immunosorbent assay.RESULTS:The results showed that HMGB1 was upregulated during liver fibrosis and that its expression was closely correlated with the deposition of collagen.siRNA molecules were successfully transfected into HSCs and induced inhibition of HMGB1 expression in a time-dependent manner.Moreover,HMGB1 siRNA treatment inhibited synthesis of α-SMA and collagen types Ⅰ and Ⅲ in transfected HSCs.CONCLUSION:This study suggests a significant functional role for HMGB1 in the development of liver fibrosis.It also demonstrates that downregulation of HMGB1 expression might be a potential strategy to treat liver fibrosis.

Inhibition of LOX-1 alleviates the proinflammatory effects of high-mobility group box 1 in Aspergillus fumigatus keratitis

AIM: To investigate the inflammatory amplification effect of high-mobility group box 1(HMGB1) in Aspergillus fumigatus(A. fumigatus) keratitis and the relationship between lectin-like oxidized low-density lipoprotein receptor 1(LOX-1) and HMGB1 in keratitis immune responses.METHODS: Phosphate buffer saline(PBS), and Boxb were injected into BALB/c mice subconjunctivally before the corneas were infected with A. fumigatus. RAW264.7 macrophages and neutrophils were pretreated with PBS and Boxb to determine the HMGB1 inflammatory amplification effects. Abdominal cavity extracted macrophages were pretreated with Boxb and Poly(I)(a LOX-1 inhibitor) before A. fumigatus hyphae stimulation to prove the the relationship between the two molecules. LOX-1, interleukin-1β(IL-1β), tumor necrosis factor-α(TNF-α), macrophage inflammatory protein-2(MIP-2) and IL-10 were assessed by polymerase chain reaction and Western blot.RESULTS: Pretreatment with Boxb exacerbated corneal inflammation. In macrophages and neutrophils, A. fumigatus induced LOX-1, IL-1β, TNF-α and MIP-2 expression in Boxb group was higher than those in PBS group. Poly(I) treatments before infection alleviated the proinflammatory effects of Boxb in abdominal cavity extracted macrophages. Pretreatment with Boxb did not influence Dectin-1 mRNA levels in macrophages and neutrophils.CONCLUSION: In fungal keratitis, HMGB1 is a proinflammatory factor in the first line of immune response. HMGB1 mainly stimulates neutrophils and macrophages to produce inflammatory cytokines and chemokines during the immune response. LOX-1 participates in HMGB1 induced inflammatory exacerbation in A. fumigatus keratitis.

Novel insights for high mobility group box 1 proteinmediated cellular immune response in sepsis:A systemic review

High mobility group box 1 protein （HMGB1） is a highly conserved, ubiquitous protein in the nuclei and cytoplasm of nearly all cell types. HMGB1 is secreted into the extracellular milieu and acts as a proinflammatory cytokine. In this article we reviewed briefly the cellular immune response mediated by HMGB1 in inflammation and sepsis. This systemic review is mainly based on our own work and other related reports HMGB1 can actively affect the immune functions of many types of cells including T lymphocytes, regulatory T cells （Tregs）, dendritic cells （DCs）, macrophages, and natural killer cells （NK cells）. Various cellular responses can be mediated by HMGB1 which binds to cell-surface receptors [e.g., the receptor for advanced glycation end products （RAGE）, Toll-like receptor （TLR）2, and TLR4]. Anti-HMGB1 treatment, such as anti-HMGB1 polyclonal or monoclonal antibodies, inhibitors （e.g., ethyl pyruvate） and antagonists （e.g., A box）, can protect against sepsis lethality and give a wider window for the treatment opportunity. HMGB1 is an attractive target for the development of new therapeutic strategies in the treatment of patients with septic complications.

儿童肺炎支原体肺炎肺泡灌洗液CARDS TX、HMGB1、TLR2表达及临床意义

目的研究肺炎支原体肺炎(MPP)患儿肺泡灌洗液中社区获得性呼吸窘迫综合征毒素(CARDS TX)、高迁移率族蛋白1(HMGB1)、Toll样受体2(TLR2)表达,探讨其在MPP发病中的临床意义。方法回顾性分析55例MPP病例组及20例对照组临床资料,同时检测两组支气管肺泡灌洗液(BALF)中CARDS TX、HMGB1、TLR2、TLR4、晚期糖基化终末产物受体(RAGE)及髓样分化因子88(MyD88)表达,体外检测不同浓度CARDS TX刺激下HMGB1、TLR2的表达并进行比较。结果与对照组相比,MPP组LYM绝对值计数、PA、CD3^(+)、CD3^(+)CD4^(+)、CD3^(+)CD8^(+)、CD3-CD19^(+)、NK cell、CD19^(+)CD23^(+)明显下降,CRP、LDH、D-二聚体、IgA、IgG、IgM、CARDS TX、HMGB1、TLR2、MyD88均升高,差异有统计学意义(P<0.05或0.001)。CARDS TX刺激后HMGB1、TLR2的表达升高,且呈正相关,差异有统计学意义(P<0.001)。结论CARDS TX可能通过HMGB1-TLR2-MyD88途径参与肺炎支原体(MP)的致病。

Inflammatory response and immune regulation of high mobility group box-1 protein in treatment of sepsis

Sepsis is an infection induced systemic inflammatory response syndrome and is a major cause of morbidity as well as mortality in intensive care units. A growing body of evidence suggests that the activation of a proinflammatory cascade is responsible for the development of immune dysfunction, susceptibility to severe sepsis and septic shock. The present theories of sepsis as a dysregulated inflammatory response and immune function, as manifested by excessive release of inflammatory mediators such as high mobility group box 1 protein （HMGB1）, are supported by increasing studies employing animal models and clinical observations of sepsis. HMGB1, originally described as a DNA-binding protein and released passively by necrotic cells and actively by macrophages/monocytes, has been discovered to be one of essential cytokines that mediates the response to infection, injury and inflammation. A growing number of studies still focus on the inflammation-regulatory function and its contribution to infectious and inflammatory disorders, recent data suggest that HMGB1 formation can also markedly influence the host cell-mediated immunity, including T lymphocytes and macrophages. Here we review emerging evidence that support extracellular HMGB1 as a late mediator of septic complications, and discuss the therapeutic potential of several HMGBl-targeting agents in experimental sepsis. In addition, with the development of traditional Chinese medicine in recent years, it has been proven that traditional Chinese herbal materials and their extracts have remarkable effective in treating severe sepsis. In this review, we therefore provide some new concepts of HMGBl-targeted Chinese herbal therapies in sepsis.

抵当汤及其拆方对深静脉血栓形成大鼠高速泳动族蛋白B1影响的研究

目的:观察抵当汤及其拆方对DVT大鼠高速泳动族蛋白B1(HMGB1)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)的影响。方法:将150只Wistar雄性大鼠随机分为5组,抵当汤组、大黄桃仁组、水蛭地龙组、模型组、假手术组,每组30只。采用Reyers法建立下腔静脉结扎模型,术后第1、3、7天灌胃2 h后,腹腔麻醉开腹,采用酶联免疫吸附试验(ELISA)、蛋白质免疫印迹法检测高速泳动族蛋白B1(HMGB1)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平,苏木精-伊红(HE)染色观察大鼠下腔静脉的病理变化,免疫荧光(IF)、实时逆转录PCR(Realtime RT-PCR)检测大鼠下腔静脉中的HMGB1表达。结果:模型组下腔静脉内皮细胞损伤严重并大量脱落,细胞肿胀明显,形成血栓,内膜形态不规则、管壁组织肿胀,胶原纤维增生,伴有炎症细胞浸润,抵当汤组、大黄桃仁组、水蛭地龙组等用药组内皮细胞不同程度损伤和炎症细胞浸润;模型组HMGB1荧光表达较假手术组明显增多,其余用药组HMGB1荧光表达不同程度减少;与假手术组比较,模型组大鼠的高速泳动族蛋白B1(HMGB1)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)血清水平、高速泳动族蛋白B1(HMGB1)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、蛋白表达、mRNA表达明显升高(P<0.01)。与模型组比较,抵当汤组、大黄桃仁组、水蛭地龙组等用药组HMGB1、IL-6、TNF-α血清水平、蛋白表达、mRNA表达明显降低(P<0.05,P<0.01)。抵当汤组、大黄桃仁组、水蛭地龙组等用药组比较,HMGB1、IL-6、TNF-α血清水平、高速泳动族蛋白B1(HMGB1)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、蛋白表达、mRNA表达比较差异有统计学意义(P<0.05,P<0.01),术后第1、3、7天比较,HMGB1、IL-6、TNF-α血清水平、蛋白表达、mRNA表达比较差异有统计学意义(P<0.05,P<0.01)。结论:抵当汤及其拆方通过降低DVT大鼠的HMGB1、IL-6、TNF-α表达,发挥对DVT的治疗作用。

Effect of high mobility group box-1 protein on immune cells and its regulatory mechanism

High mobility group box-1 protein(HMGB1),which is a nuclear protein,participates in chromatin architecture and transcriptional regulation.When released from cells,HMGB1 also plays a well-established role as a pro-inflammatory mediator during innate immune responses to injury.In the initial stage of injury,there is a release of large quantities of early pro-inflammatory mediators to initiate or perpetuate immune responses against pathogens,but this pro-inflammatory period is transient,and it is followed by a prolonged period of immune suppression.At present,several lines of evidences have suggested that HMGB1 is a late cytokine provoking delayed endotoxin morbidity,which may enhance the production of early proinflammatory mediators,and it can contribute potently to the activation of different immune cells and play a role in the development of host cell-mediated immunity.The biology of HMGB1 has been extensively studied as a pro-inflammatory cytokine of systemic inflammation,however,this review will attempt to provide a summary of the effects of HMGB1 on different immune cells and its regulatory mechanism in acute insults.

穿心莲内酯调节HMGB1/RAGE信号通路对糖尿病周围神经病变大鼠坐骨神经功能损伤的影响

目的探讨穿心莲内酯调节高迁移率族蛋白B1(HMGB1)/晚期糖基化终产物受体(RAGE)信号通路对糖尿病周围神经病变(DPN)大鼠坐骨神经功能损伤的影响。方法将84只大鼠随机分为对照组(生理盐水)、DPN组(生理盐水)、穿心莲内酯低剂量组(0.833 mg/kg)、穿心莲内酯高剂量组(3.332 mg/kg)、硫辛酸组(阳性对照,0.1 g/kg)、重组大鼠HMGB1蛋白(rHMGB1,8μg/kg)组、穿心莲内酯高剂量+rHMGB1组,每组12只。除对照组外,其余各组大鼠均采用高糖高脂饲料喂养联合腹腔注射链脲佐菌素的方式构建DPN模型。造模成功24 h后,进行给药处理,每天1次,持续8周。给药结束后,检测大鼠空腹血糖、机械痛阈值、热痛阈值、坐骨神经传导速度的变化;观察大鼠坐骨神经病理变化;检测大鼠坐骨神经中超氧化物歧化酶(SOD)活性及丙二醛(MDA)含量;检测大鼠坐骨神经中HMGB1、RAGE蛋白表达水平和核因子κB p65(NF-κB p65)蛋白磷酸化水平。结果与对照组比较,DPN组大鼠坐骨神经病理损伤严重,空腹血糖、热痛阈值、MDA含量及HMGB1、RAGE蛋白表达水平和NF-κB p65蛋白磷酸化水平均显著升高(P<0.05),机械痛阈值、感觉神经传导速度、运动神经传导速度、SOD活性显著降低/减慢(P<0.05);与DPN组比较,穿心莲内酯低、高剂量组和硫辛酸组大鼠上述指标均显著改善(P<0.05),rHMGB1组对应指标变化趋势与上述3个给药组相反(P<0.05);并且,rHMGB1可减弱高剂量穿心莲内酯对DPN大鼠血糖的降低作用及坐骨神经氧化应激损伤的改善作用(P<0.05)。结论穿心莲内酯可能通过抑制HMGB1/RAGE信号通路来降低血糖、抑制氧化应激,进而改善DPN大鼠坐骨神经损伤。

食管癌术后重症肺炎患者血清肺表面活性物质相关蛋白质-D、高迁移率族蛋白B1和中性粒细胞与淋巴细胞比值水平变化及检测意义

目的:探讨中性粒细胞与淋巴细胞比值(NLR)、肺表面活性物质相关蛋白质-D(SP-D)及高迁移率族蛋白B1(HMGB1)在食管癌术后重症肺炎(SP)患者中的水平变化及检测意义。方法:选取接受手术治疗的食管癌患者257例,根据手术治疗后是否发生SP将患者分为SP组(124例)和对照组(133例)。比较两组血清SP-D、HMGB1和NLR水平。记录SP组患者28 d内预后情况,根据28 d内生存情况将SP组患者分为生存组(104例)和病死组(20例)。比较两组一般资料及实验室指标,采用Logistic回归分析食管癌术后SP患者预后影响因素。绘制受试者工作特征(ROC)曲线分析NLR、SP-D及HMGB1对食管癌术后SP患者28 d内病死风险的预测价值。结果:SP组血清SP-D及HMGB1和NLR水平高于对照组(均P<0.05)。病死组NLR、SP-D及HMGB1水平高于生存组(均P<0.05)。NLR、SP-D及HMGB1是食管癌术后SP患者病死的影响因素(均P<0.05)。NLR、SP-D及HMGB1预测食管癌术后SP患者28 d内病死风险的AUC分别为0.744、0.763、0.715,而三者联合检测的AUC更高(均P<0.05)。结论:食管癌术后SP患者NLR、SP-D及HMGB1水平升高,且与患者预后有关,三者联合检测有助于提升对患者病死风险的预测价值。

术前血清sTim-3、HMGB1水平与肌层浸润性膀胱癌根治术后预后的关系

目的探讨术前血清可溶性T细胞免疫球蛋白黏蛋白分子-3(sTim-3)、高迁移率族蛋白B1(HMGB1)水平与肌层浸润性膀胱癌(MIBC)根治术后预后的关系。方法选取2019年6月至2020年6月该院收治的85例MIBC患者作为MIBC组,另选取同期在该院体检的85例健康者作为对照组。采用酶联免疫吸附试验(ELISA)检测所有受试者血清sTim-3、HMGB1水平;根据血清sTim-3、HMGB1水平均值将MIBC患者分为sTim-3高表达组(≥均值)和sTim-3低表达组(<均值)、HMGB1高表达组(≥均值)和HMGB1低表达组(<均值)。对比各组血清sTim-3、HMGB1水平,以及不同sTim-3、HMGB1水平与MIBC患者病理特征的关系。采用Pearson相关分析MIBC患者血清sTim-3水平与血清HMGB1水平的相关性;采用Kaplan-Meier生存曲线分析不同血清sTim-3、HMGB1水平MIBC患者的生存预后情况。结果MIBC组患者血清sTim-3、HMGB1水平高于对照组(P<0.05)。Pearson相关性分析结果显示,MIBC组患者血清sTim-3水平与血清HMGB1水平呈正相关(r=0.405,P<0.001)。不同年龄、性别、肿瘤最大径及是否发生淋巴结转移MIBC患者的血清sTim-3、HMGB1水平比较,差异均无统计学意义(P>0.05),而不同TNM分期、组织分级、淋巴结状态MIBC患者的血清sTim-3、HMGB1水平比较,差异均有统计学意义(P<0.05)。根据血清sTim-3、HMGB1水平的均值将85例MIBC患者分为sTim-3高表达组(≥3.67 ng/mL,n=44)和sTim-3低表达组(<3.67 ng/mL,n=41)、HMGB1高表达组(≥14.91 ng/mL,n=47)和HMGB1低表达组(<14.91 ng/mL,n=38)。Kaplan-Meier生存曲线结果显示,sTim-3低表达组患者的3年生存曲线高于sTim-3高表达组患者(Log-rankχ^(2)=6.175,P=0.013),HMGB1低表达组患者的3年生存曲线高于HMGB1高表达组患者(Log-rankχ^(2)=4.056,P=0.044)。sTim-3高表达组与sTim-3低表达组MIBC患者的3年生存率分别为52.27%、78.05%,HMGB1高表达组与HMGB1低表达组MIBC患者3年生存率分别为55.32%、76.31%。结论血清sTim-3、HMGB1在MIBC患者中呈高表达,且二者水平呈正相关,可作为评估MIBC患者预后不良的重要指标。

多发性骨髓瘤患者血清β2-MG、HMGB1水平与分期的相关性分析

目的:分析多发性骨髓瘤(multiple myeloma,MM)患者血清β2微球蛋白(β2-microglobulin,β2-MG)、高迁移率族蛋白B1(high mobility group protein B1,HMGB1)水平与分期的相关性。方法:回顾性分析2020年8月至2023年7月在平顶山市第一人民医院进行治疗的106例MM患者的临床资料,将其设为观察组,另选同期于本院体检中心体检健康的100例志愿者设为对照组,比较两组血清β2-MG、HMGB1水平,比较不同分期MM患者的血清β2-MG、HMGB1水平,采用Spearman相关系数分析MM患者临床分期与血清β2-MG、HMGB1水平的相关性,比较不同预后MM患者的血清β2-MG、HMGB1水平。结果:观察组血清β2-MG、HMGB1水平均高于对照组(P<0.05);Ⅰ期患者血清β2-MG、HMGB1水平低于Ⅱ期患者,Ⅱ期患者β2-MG、HMGB1水平低于Ⅲ期患者(P<0.05);相关性分析显示,MM患者临床分期与血清β2-MG、HMGB1水平呈正相关(P<0.05);完全缓解患者血清β2-MG、HMGB1水平低于部分缓解患者,部分缓解患者血清β2-MG、HMGB1水平低于复发患者(P<0.05)。结论:MM患者的血清β2-MG、HMGB1水平与其临床分期、预后关系密切,随着患者临床分期增加,其血清β2-MG、HMGB1水平随之升高,临床诊治时可结合以上指标判断患者病情进展,预测预后。