The clinical significance of serum level of HMGB1 in severe hepatitis B

Objective: To explore the clinical significance of serum level of high-mobility group box 1 protein (HMGB1) in severe hepatitis B (SHB). Methods: The serum level of HMGB1 was detected by enzyme-linked immunosorbent assay (ELISA) in 70 patients with chronic SHB (CSHB), 70 patients with chronic HBV infection and 35 healthy subjects. The serum level of HMGB1 of 30 patients with CSHB was observed dynamically at three time points, namely, on admission, the 7th and 14th day of admission. The model for end-stage liver disease (MELD) scores of 70 patients with CSHB were calculated according to the 2002 Standard Edition (μmol/L) formula. Results: The serum level of HMGB1(μg/L) in the normal controls, patients with chronic HBV infection, and patients with CSHB was 14.29±4.01, 49.68±7.72, and 61.92±15.42, respectively. Pairwise comparisons among the three groups showed that the serum level of HMGB1 was significantly higher in CSHB patients than in patients with chronic HBV infection and the normal controls (P<0.01); the serum level of HMGB1 was significantly higher in patients with chronic HBV infection than in the normal controls (P<0.01). The serum level of HMGB1(μg/L) was 62.02±16.16 in CSHB survival subgroup and 62.59±14.97 in CSHB non-survival subgroup, with no significant difference between the two (P>0.05). No significant correlation was found between the serum level of HMGB1 and MELD scores (P>0.05). In the 30 CSHB patients who were observed dynamically on admission, the 7th and 14th day of admission, the serum level of HMGB1 decreased gradually after admission in the non-survival group, but in the survival group it decreased to the lowest at the 7th day after admission and then increased gradually. Conclusion: Our study found that the serum level of HMGB1 significantly increased in CSHB, indicating that HMGB1 is involved in the pathogenesis and development of the disease. The serum level of HMGB1 has no obvious correlation with MELD scores or the prognosis. Dynamic monitoring of the serum level of HMGB1 may be significant in predicting the prognosis of SHB.