Abstract
Background
High mobility group box-1 (HMGB-1), a recently identified inflammatory cytokine, is
implicated in the pathogenesis of several inflammatory, infective and neoplastic processes.
Patterns of expression following blunt trauma have not been adequately reported in
the literature. This study aimed to quantify the serum concentrations of HMGB-1 following
blunt trauma, and assess its relationship with the more established interleukin 6
(IL-6).
Patients and methods
20 patients with median injury severity score 17 (range 9–36) sustaining closed diaphyseal
fractures of the femur treated by intramedullary nailing were included in the study.
Serum concentrations of HMGB-1 and IL-6 were measured at several time points during
their treatment.
Results
A strong correlation was observed between admission and day 1 post-op concentrations
of IL-6 and both the injury severity score (ISS) and the requirement for intensive
care unit treatment. Serum concentrations of HMGB-1 did not demonstrate such a correlation.
Around day 3 when IL-6 concentrations begin to fall, serum HMGB-1 concentrations were
observed to increase.
Conclusions
IL-6 concentration measured early after admission is again shown to be strongly associated
with overall injury severity and requirement for intensive care unit treatment. In
contrast, HMGB-1 appears to be a late inflammatory mediator with levels becoming elevated
once serum concentrations of IL-6 begin to fall. However, we were unable to demonstrate
any relationship with injury severity or requirement for ICU care at any stage. These
preliminary findings may form the basis for future research in this area.
Keywords
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Further reading
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Article info
Publication history
Accepted:
September 7,
2010
Footnotes
☆Work attributed to: Academic Department of Trauma & Orthopaedics, Leeds Teaching Hospitals, University of Leeds, Leeds General Infirmary, Clarendon Wing, Level A, Great George Street, LS1 3EX Leeds, UK, and Academic Department of Trauma & Orthopaedics, Aachen University Hospital, Aachen, Germany.
Identification
Copyright
© 2010 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
