| Objective: To validate the role of high mobility group box 1(HMGB1)in Hemophagocytic Lymphohistiocytosis(HLH)patients and its significance.Methods: 36 patients of hemophagocytic lymphohistiocytosis and 30 healthy volunteers were recruited,their clinical data were collected in this study.The serum level and m RNA level of HMGB1 in peripheral blood were measured by ELISA and quantitative real-time PCR,respectively.The correlation between HMGB1 level and clinical data were analyzed,the optimal cut-off value,sensitivity and specificity of HMGB1 and ferritin for the diagnosis of HLH were analyzed.The pathophysiological role of HMGB1 in HLH were analyzed by GSEA method.Results:The mean value of serum HMGB1 concentrations in HLH patients were significantly higher than healthy control(1879.94±789.87ng/ml vs 1237.49±272.85ng/ml,P<0.05),and the m RNA levels of HMGB1 in HLH patients were obviously increased than healthy control(4.56±2.10 folds vs 2.34±1.32 folds,P<0.05).The concentrations of HMGB1 was positively correlated with ferritin(r=0.6144,P=0.0335)and negatively correlated with RBC(r =-0.4341,P=0.0082),hemoglobin(r =-0.3947,P=0.0172)and platelet(r =-0.4715,P=0.0037).The concentrations of HMGB1 in HLH patients with hemophagocytosis in bone marrow were significantly higher than those without(2120.20±841.8ng/ml vs 1478.79±309.86ng/ml,P<0.05).The area under curve(AUC)of HLH diagnosed by HMGB1 was 0.8329(P<0.05),the AUC of HLH diagnosed by HMGB1 and ferritin was 0.917(P=0.00003).The optimal diagnostic cut-off value was 1522ng/ml,with a sensitivity of 72.22% and specificity of 86.67%.GSEA revealed that HMGB1 expression positively correlated with ribosome,primary immunodeficiency,citrate cycle,TCA cycle,nucleotide excision repair,valine,leucine and isoleucine degradation pathways.Conclusion:High mobility group protein B1 has certain value in diagnosis and evaluation of hemophagocytic lymphohistiocytosis,which is expected to become a novel diagnostic and evaluation biomarker. |
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