Association of plasma level of high-mobility group box-1 with necroptosis and sepsis outcomes

Abstract The role of high-mobility group box-1 (HMGB1) in outcome prediction in sepsis is controversial. Furthermore, its association with necroptosis, a programmed cell necrosis mechanism, is still unclear. The purpose of this study is to identify the association between the plasma levels of HMGB1...

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Main Authors: Hongseok Yoo, Yunjoo Im, Ryoung-Eun Ko, Jin Young Lee, Junseon Park, Kyeongman Jeon
Format: Article
Language:English
Published: Nature Portfolio 2021-05-01
Series:Scientific Reports
Online Access:https://doi.org/10.1038/s41598-021-88970-6
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author Hongseok Yoo
Yunjoo Im
Ryoung-Eun Ko
Jin Young Lee
Junseon Park
Kyeongman Jeon
author_facet Hongseok Yoo
Yunjoo Im
Ryoung-Eun Ko
Jin Young Lee
Junseon Park
Kyeongman Jeon
author_sort Hongseok Yoo
collection DOAJ
description Abstract The role of high-mobility group box-1 (HMGB1) in outcome prediction in sepsis is controversial. Furthermore, its association with necroptosis, a programmed cell necrosis mechanism, is still unclear. The purpose of this study is to identify the association between the plasma levels of HMGB1 and the severity and clinical outcomes of sepsis, and to examine the correlation between HMGB1 and key executors of necroptosis including receptor-interacting kinase 3 (RIPK3) and mixed lineage kinase domain-like- (MLKL) proteins. Plasma HMGB1, RIPK3, and MLKL levels were measured with the enzyme-linked immunosorbent assay from the derivation cohort of 188 prospectively enrolled, critically-ill patients between April 2014 and December 2016, and from the validation cohort of 77 patients with sepsis between January 2017 and January 2019. In the derivation cohort, the plasma HMGB1 levels of the control (n = 46, 24.5%), sepsis (n = 58, 30.9%), and septic shock (n = 84, 44.7%) groups were significantly increased (P < 0.001). A difference in mortality between high (≥ 5.9 ng/mL) and low (< 5.9 ng/mL) HMGB1 levels was observed up to 90 days (Log-rank test, P = 0.009). There were positive linear correlations of plasma HMGB1 with RIPK3 (R2 = 0.61, P < 0.001) and MLKL (R2 = 0.7890, P < 0.001). The difference in mortality and correlation of HMGB1 levels with RIPK3 and MLKL were confirmed in the validation cohort. Plasma levels of HMGB1 were associated with the severity and mortality attributed to sepsis. They were correlated with RIPK3 and MLKL, thus suggesting an association of HMGB1 with necroptosis.
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spelling doaj.art-0a3218336d134e7480d501b1327c56ea2022-12-21T23:10:57ZengNature PortfolioScientific Reports2045-23222021-05-011111910.1038/s41598-021-88970-6Association of plasma level of high-mobility group box-1 with necroptosis and sepsis outcomesHongseok Yoo0Yunjoo Im1Ryoung-Eun Ko2Jin Young Lee3Junseon Park4Kyeongman Jeon5Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineAbstract The role of high-mobility group box-1 (HMGB1) in outcome prediction in sepsis is controversial. Furthermore, its association with necroptosis, a programmed cell necrosis mechanism, is still unclear. The purpose of this study is to identify the association between the plasma levels of HMGB1 and the severity and clinical outcomes of sepsis, and to examine the correlation between HMGB1 and key executors of necroptosis including receptor-interacting kinase 3 (RIPK3) and mixed lineage kinase domain-like- (MLKL) proteins. Plasma HMGB1, RIPK3, and MLKL levels were measured with the enzyme-linked immunosorbent assay from the derivation cohort of 188 prospectively enrolled, critically-ill patients between April 2014 and December 2016, and from the validation cohort of 77 patients with sepsis between January 2017 and January 2019. In the derivation cohort, the plasma HMGB1 levels of the control (n = 46, 24.5%), sepsis (n = 58, 30.9%), and septic shock (n = 84, 44.7%) groups were significantly increased (P < 0.001). A difference in mortality between high (≥ 5.9 ng/mL) and low (< 5.9 ng/mL) HMGB1 levels was observed up to 90 days (Log-rank test, P = 0.009). There were positive linear correlations of plasma HMGB1 with RIPK3 (R2 = 0.61, P < 0.001) and MLKL (R2 = 0.7890, P < 0.001). The difference in mortality and correlation of HMGB1 levels with RIPK3 and MLKL were confirmed in the validation cohort. Plasma levels of HMGB1 were associated with the severity and mortality attributed to sepsis. They were correlated with RIPK3 and MLKL, thus suggesting an association of HMGB1 with necroptosis.https://doi.org/10.1038/s41598-021-88970-6
spellingShingle Hongseok Yoo
Yunjoo Im
Ryoung-Eun Ko
Jin Young Lee
Junseon Park
Kyeongman Jeon
Association of plasma level of high-mobility group box-1 with necroptosis and sepsis outcomes
Scientific Reports
title Association of plasma level of high-mobility group box-1 with necroptosis and sepsis outcomes
title_full Association of plasma level of high-mobility group box-1 with necroptosis and sepsis outcomes
title_fullStr Association of plasma level of high-mobility group box-1 with necroptosis and sepsis outcomes
title_full_unstemmed Association of plasma level of high-mobility group box-1 with necroptosis and sepsis outcomes
title_short Association of plasma level of high-mobility group box-1 with necroptosis and sepsis outcomes
title_sort association of plasma level of high mobility group box 1 with necroptosis and sepsis outcomes
url https://doi.org/10.1038/s41598-021-88970-6
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