Targeting circulating high mobility group box-1 and histones by extracorporeal blood purification as an immunomodulation strategy against critical illnesses
Abstract Both high mobility group box-1 (HMGB1) and histones are major damage-associated molecular patterns (DAPMs) that mediate lethal systemic inflammation, activation of the complement and coagulation system, endothelial injury and multiple organ dysfunction syndrome in critical illnesses. Althou...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-02-01
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| Series: | Critical Care |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13054-023-04382-0 |
| _version_ | 1797864544863780864 |
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| author | Yupei Li Yu Chen Tinghang Yang Kaixi Chang Ningyue Deng Weifeng Zhao Baihai Su |
| author_facet | Yupei Li Yu Chen Tinghang Yang Kaixi Chang Ningyue Deng Weifeng Zhao Baihai Su |
| author_sort | Yupei Li |
| collection | DOAJ |
| description | Abstract Both high mobility group box-1 (HMGB1) and histones are major damage-associated molecular patterns (DAPMs) that mediate lethal systemic inflammation, activation of the complement and coagulation system, endothelial injury and multiple organ dysfunction syndrome in critical illnesses. Although accumulating evidence collectively shows that targeting HMGB1 or histones by their specific antibodies or inhibitors could significantly mitigate aberrant immune responses in multiple critically ill animal models, routine clinical use of such agents is still not recommended by any guideline. In contrast, extracorporeal blood purification, which has been widely used to replace dysfunctional organs and remove exogenous or endogenous toxins in intensive care units, may also exert an immunomodulatory effect by eliminating inflammatory mediators such as cytokines, endotoxin, HMGB1 and histones in patients with critical illnesses. In this review, we summarize the multiple immunopathological roles of HMGB1 and histones in mediating inflammation, immune thrombosis and organ dysfunction and discuss the rationale for the removal of these DAMPs using various hemofilters. The latest preclinical and clinical evidence for the use of extracorporeal blood purification to improve the clinical outcome of critically ill patients by targeting circulating HMGB1 and histones is also gathered. |
| first_indexed | 2024-04-09T22:54:40Z |
| format | Article |
| id | doaj.art-2519946a77874c849354fce014a497a8 |
| institution | Directory Open Access Journal |
| issn | 1364-8535 |
| language | English |
| last_indexed | 2024-04-09T22:54:40Z |
| publishDate | 2023-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Critical Care |
| spelling | doaj.art-2519946a77874c849354fce014a497a82023-03-22T11:21:13ZengBMCCritical Care1364-85352023-02-0127111110.1186/s13054-023-04382-0Targeting circulating high mobility group box-1 and histones by extracorporeal blood purification as an immunomodulation strategy against critical illnessesYupei Li0Yu Chen1Tinghang Yang2Kaixi Chang3Ningyue Deng4Weifeng Zhao5Baihai Su6Department of Nephrology, West China Hospital, Sichuan UniversityState Key Laboratory of Polymer Materials Engineering, College of Polymer Science and Engineering, Sichuan UniversityDepartment of Nephrology, West China Hospital, Sichuan UniversityDepartment of Nephrology, West China Hospital, Sichuan UniversityDepartment of Nephrology, West China Hospital, Sichuan UniversityState Key Laboratory of Polymer Materials Engineering, College of Polymer Science and Engineering, Sichuan UniversityDepartment of Nephrology, West China Hospital, Sichuan UniversityAbstract Both high mobility group box-1 (HMGB1) and histones are major damage-associated molecular patterns (DAPMs) that mediate lethal systemic inflammation, activation of the complement and coagulation system, endothelial injury and multiple organ dysfunction syndrome in critical illnesses. Although accumulating evidence collectively shows that targeting HMGB1 or histones by their specific antibodies or inhibitors could significantly mitigate aberrant immune responses in multiple critically ill animal models, routine clinical use of such agents is still not recommended by any guideline. In contrast, extracorporeal blood purification, which has been widely used to replace dysfunctional organs and remove exogenous or endogenous toxins in intensive care units, may also exert an immunomodulatory effect by eliminating inflammatory mediators such as cytokines, endotoxin, HMGB1 and histones in patients with critical illnesses. In this review, we summarize the multiple immunopathological roles of HMGB1 and histones in mediating inflammation, immune thrombosis and organ dysfunction and discuss the rationale for the removal of these DAMPs using various hemofilters. The latest preclinical and clinical evidence for the use of extracorporeal blood purification to improve the clinical outcome of critically ill patients by targeting circulating HMGB1 and histones is also gathered.https://doi.org/10.1186/s13054-023-04382-0High mobility group box-1HistoneExtracorporeal blood purificationInflammationSepsisCritical illness |
| spellingShingle | Yupei Li Yu Chen Tinghang Yang Kaixi Chang Ningyue Deng Weifeng Zhao Baihai Su Targeting circulating high mobility group box-1 and histones by extracorporeal blood purification as an immunomodulation strategy against critical illnesses Critical Care High mobility group box-1 Histone Extracorporeal blood purification Inflammation Sepsis Critical illness |
| title | Targeting circulating high mobility group box-1 and histones by extracorporeal blood purification as an immunomodulation strategy against critical illnesses |
| title_full | Targeting circulating high mobility group box-1 and histones by extracorporeal blood purification as an immunomodulation strategy against critical illnesses |
| title_fullStr | Targeting circulating high mobility group box-1 and histones by extracorporeal blood purification as an immunomodulation strategy against critical illnesses |
| title_full_unstemmed | Targeting circulating high mobility group box-1 and histones by extracorporeal blood purification as an immunomodulation strategy against critical illnesses |
| title_short | Targeting circulating high mobility group box-1 and histones by extracorporeal blood purification as an immunomodulation strategy against critical illnesses |
| title_sort | targeting circulating high mobility group box 1 and histones by extracorporeal blood purification as an immunomodulation strategy against critical illnesses |
| topic | High mobility group box-1 Histone Extracorporeal blood purification Inflammation Sepsis Critical illness |
| url | https://doi.org/10.1186/s13054-023-04382-0 |
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