High mobility group box protein-1 (HMGB-1) as a new diagnostic marker in patients with acute appendicitis

Abstract

BackgroundThe aim of this prospective study was therefore to evaluate the diagnostic value of preoperative serum High Mobility Group Box Protein-1 (HMGB-1) levels in patients with Acute Appendicitis (AA) who show normal white blood cell count (WBC) counts.MethodOur study was carried out from October 2010 through November 2010 and included 20 healthy control group participants and 60 patients who presented at the emergency department of Erzurum Training and Research Hospital in Turkey with acute abdominal pain complaints, who were pathologically diagnosed with AA after laparotomy, and who agreed to participate in the study.ResultsOf the 60 patients who underwent appendectomies, 36 were male and 24 were female, and of the healthy group, 12 were male and 8 female. The age averages of the patients in Groups 1, 2 and 3 were, respectively, 31.3+15.4, 34.0+16.3 and 31.0+13.1 years. The WBC averages of Groups 1, 2 and 3 were, respectively, 7.41+2.02 (x109/L), 15.71+2.85 (x109/L) and 8.51+1.84 (x109/L). The HMGB-1 levels for Groups 1 (healthy persons), 2 (AA patients with high WBC counts ) and 3 (AA patients with normal WBC counts) were, respectively, 21.71 ± 11.36, 37.28+13.37 and 36.5 ± 17.73 ng/ml. The average HMGB-1 level of the patients with AA was 36.92 ± 15.43 ng/ml while the average HMGB-1 value of the healthy group was 21.71 ± 11.36 ng/ml.ConclusionThe significantly higher levels of HMGB-1 in AA patients compared to healthy persons infer that HMGB-1 might be useful in the diagnosis of AA. Use of HMGB-1, especially in patients with normal WBC counts, will reduce the number of unnecessary explorations.

HMGB1 in health and disease

“…HMGB1 is involved in pathophysiological pain from cancer (Tong et al, 2010), acute appendicitis (Albayrak et al, 2011), type 2 diabetes (Ren et al, 2012), bladder pain (Tanaka et al, 2014), and neuropathic pain (Maeda et al, 2013). Neuropathic pain is caused by nervous system injury and persistent alterations in pain sensitivity.…”

“…In the gastrointestinal tract, increased levels of HMGB1 have positively correlated with intestinal barrier dysfunction and colonic inflammation in mice (Dave et al, 2009; Liu et al, 2006; Luan et al, 2010; Maeda et al, 2007; Sappington et al, 2002; Wu et al, 2009; Yang et al, 2009a). Moreover, fecal HMGB1 is a novel biomarker of intestinal mucosal inflammation in patients with inflammatory bowel disease (Vitali et al, 2011), whereas serum HMGB1 is diagnostic marker in patients with acute appendicitis (Albayrak et al, 2011; Soreide, 2011; Wu et al, 2012a). TLR4 and TLR2 are required for the HMGB1-mediated inflammatory response and injury in inflammatory bowel disease, as well as necrotizing enterocolitis (Dai et al, 2010; Downard et al, 2011; Lu et al, 2013b; McDonnell et al, 2011; Zamora et al, 2005).…”

Serum HMGB1 as a Potential Biomarker for Patients with Asbestos-Related Diseases

“…Recent clinical studies have shown that HMGB1 is a potential diagnostic or prognostic biomarker in a variety of inflammatory disorders [10–12] and cancers [13–19]. One group from the USA provided the first evidence that HMGB1 was highly expressed in both tissues and sera of mesothelioma patients [20].…”

A Review of the Predictive Role of Plasma D-Lactate Level in Acute Appendicitis: A Myth or Truth?

“…Additionally, some biomarkers most frequently investigated in this context are cytokines, adhesion molecules, interleukins-especially interleukin-6, procalcitonin (PCT), urinary leucine-rich alpha-2-glycoprotein (LRG), S100A8/A9, high mobility group box-1 protein (HMGB1), and D-lactate [5–14]. …”