Clinical prognostic significance of serum high mobility group box-1 protein in patients with community-acquired pneumonia

OBJECTIVE: To investigate the relationship between serum high mobility group box-1 protein (HMGB-1) levels and prognosis in patients with community-acquired pneumonia (CAP). METHODS: This prospective study included 35 patients who attended our hospital from January 2016 to December 2016. Pneumonia severity was defined by pneumonia severity index (PSI). Serum levels of C-reactive protein (CRP), cortisol, and HMGB-1 were analyzed in relation to disease severity and clinical outcome. RESULTS: High HMGB-1 levels were associated with high cortisol levels. High HMGB-1 and high cortisol were both significantly associated with high white blood cell count and high serum CRP, compared with low HMGB-1 and low cortisol, respectively. PSI score and 30-day mortality were also significantly higher in patients with high HMGB-1 or high cortisol levels compared with patients with low HMGB-1 or cortisol levels, respectively. CRP, cortisol, and HMGB-1 levels were all significantly higher in patients who died compared with survivors. CONCLUSION: HMGB-1 was associated with clinical outcomes and was an independent risk factor for 30-day mortality in patients with CAP. Serum HMGB-1 levels were also positively correlated with serum levels of cortisol. These results demonstrate a role for HMGB-1 in CAP, and suggest possible new therapeutic targets for patients with CAP.