Expression and clinical significance of high mobility group protein B1 in patients with hemophagocytic lymphohistiocytosis

Abstract

Objective To detect the expression of high mobility group box 1 (HMGB1) in hemophagocytic lymphohistiocytosis (HLH) patients and explore its clinical significance in the disease. Methods A total of 26 HLH patients admitted in our hospital from July 2018 to May 2019 were recruited, and their clinical data were collected in this study. Thirty healthy volunteers were recruited as normal control. The serum level and mRNA level of HMGB1 in peripheral blood samples were measured by ELISA and quantitative real-time PCR, respectively. The correlation between HMGB1 level and clinical data were analyzed, and the optimal cut-off value, sensitivity and specificity of HMGB1 for the diagnosis of HLH were analyzed. Results The serum HMGB1 level was significantly higher in HLH patients than healthy volunteers (1 992.77±883.74 vs 1 237.49±272.85 ng/mL, P < 0.01)]. And the mRNA level of the molecule was also obviously increased in the HLH patients than the healthy control (4.56±2.10 vs 2.34±1.32, P < 0.05). The serum level of HMGB1 was negatively correlated with red blood cell count (r=-0.514 6, P < 0.05), hemoglobin level (r=-0.453 6, P < 0.05) and platelet count (r=-0.505 5, P < 0.05). The serum level of HMGB1 was notably higher in the HLH patients with hemophagocytosis in bone marrow than those without (2 246.27±935.14 vs 1 422.38±317.33 ng/mL, P < 0.05). The area under the curve (AUC) of HLH diagnosed by HMGB1 was 0.812 2 (P < 0.05) and the optimal cut-off value was 1 522 ng/mL, with a sensitivity of 69.23% and specificity of 86.67%. Conclusion HMGB1 is highly expressed in the peripheral blood of HLH patients, and can be used in the diagnosis, evaluation and prognosis of the disease.

Keywords

• hemophagocytic lymphohistiocytosis
• high mobility group protein b1
• sensitivity
• specificity