High-mobility group box 1 protein plasma concentrations during septic shock

• Published in: Intensive care medicine 2007-08, Vol.33 (8), p.1347-1353
• Main Authors: GIBOT, Sébastien, MASSIN, Frédéric, CRAVOISY, Aurélie, BARRAUD, Damien, NACE, Lionel, LEVY, Brune, BOLLAERT, Pierre-Edouard
• Format: Article
• Language: English
• Subjects: Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Biomarkers; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis; Calcitonin - analysis; Calcitonin - blood; Calcitonin - metabolism; Calcitonin Gene-Related Peptide; Emergency and intensive care: infection, septic shock; Enzyme-Linked Immunosorbent Assay; Female; France; HMGB1 protein; HMGB1 Protein - analysis; HMGB1 Protein - blood; HMGB1 Protein - metabolism; Humans; Inflammation - metabolism; Intensive care; Intensive care medicine; Intensive Care Units; Lactic acid; Male; Medical prognosis; Medical sciences; Middle Aged; Mobility; Multiple Organ Failure - physiopathology; Patients; Physiology; Plasma; Procalcitonin; Prospective Studies; Protein Precursors - analysis; Protein Precursors - blood; Protein Precursors - metabolism; Proteins; Sepsis; Septic shock; Shock, Septic - metabolism; Shock, Septic - physiopathology; Steroids; Survival; Transfusions. Complications. Transfusion reactions. Cell and gene therapy
• ISSN: 0342-4642; 1432-1238
• DOI: 10.1007/s00134-007-0691-2

To investigate plasma high-mobility group box 1 protein (HMGB1) concentration and its relationship with organ dysfunction and outcome in septic shock patients. Prospective, noninterventional study. Medical adult intensive care unit at a university hospital in France. 42 critically ill patients with septic shock. Arterial blood was drawn within 12 h of admission for the measurement of plasma HMGB1 concentration by ELISA. Repeated sampling was performed on days 3, 7, and 14. Median HMGB1 concentration was 4.4 ng/ml (IQR 1.2-12.5) at admission, with no difference between survivors and nonsurvivors. A positive correlation was observed between HMGB1 and SOFA score and lactate, and procalcitonin concentrations. There was a progressive but statistically nonsignificant decline in HMGB1 concentration among the survivors, while nonsurvivors showed an increase in HMGB1 level between days 1 and 3. SOFA score and lactate and procalcitonin concentrations did not vary significantly between days 1 and 3. When measured on day 3, HMGB1 discriminated survivors from nonsurvivors with 66% sensitivity and 67% specificity, and concentration greater than 4 ng/ml was associated with an odds ratio of death of 5.5 (95% CI 1.3-23.6).