Higher High-Mobility Group Box-1 Levels are Associated with White Matter Lesions in Ischemic Stroke Patients

Jie Zhao; Fang Xu; Wanying Xu; Rong Lv; Juan Wang; Xufeng Yang

doi:10.2147/JIR.S432109

Higher High-Mobility Group Box-1 Levels are Associated with White Matter Lesions in Ischemic Stroke Patients

J Inflamm Res. 2023 Oct 9:16:4441-4449. doi: 10.2147/JIR.S432109. eCollection 2023.

Authors

Jie Zhao¹, Fang Xu², Wanying Xu¹, Rong Lv¹, Juan Wang³, Xufeng Yang¹

Affiliations

¹ Department of Geriatrics, Suzhou Ninth People's Hospital, Soochow University, Suzhou, Jiangsu, 215200, People's Republic of China.
² Department of Obstetrics and Gynecology, Suzhou Wujiang District Hospital of Traditional Chinese Medicine, Suzhou, Jiangsu, 215200, People's Republic of China.
³ Department of Endocrine, Suzhou Ninth People's Hospital, Soochow University, Suzhou, Jiangsu, 215200, People's Republic of China.

Abstract

Background and purpose: High-mobility group box-1 (HMGB1) is a useful biomarker for disease severity stratification and prognosis prediction. We aim to explore whether the circulating HMGB1 concentrations are associated with the white matter lesions (WMLs) burden in stroke patients.

Methods: Between 2022 June and December 2022, patients with acute ischemic stroke were prospectively enrolled. HMGB1 levels were measured by an enzyme-linked immunosorbent assay after admission for all patients. The WMLs severity was assessed by the Fazekas scale. We dichotomized patients into those with moderate-severe WMLs (Fazekas score 3-6) versus those with none-mild WMLs (Fazekas score 0-2). Furthermore, based on the severity of periventricular WMLs (PWMLs) and deep WMLs (DWMLs), patients were categorized as none-mild (Fazekas score 0-1) or moderate-severe (Fazekas score 2-3).

Results: A total of 287 participants (mean age: 64.9 years; 157 male) were analyzed. The median serum HMGB1 levels were 7.3 ng/mL (interquartile, 4.3 ng/mL-12.3 ng/mL). After adjustment for potential confounders, elevated HMGB1 levels were associated with the presence of moderate-severe WMLs (first quartile vs fourth quartile, odds ratio [OR], 4.101; 95% confidence interval [CI], 1.948-8.633; P = 0.001) and moderate-severe PWMLs (first quartile vs fourth quartile, OR, 9.181; 95% CI, 4.078-20.671; P = 0.001). Similar results were found when the HMGB1 levels were analyzed as a continuous variable.

Conclusion: This study demonstrated that increased HMGB1 levels were associated with the severity of WMLs, mainly in the periventricular region.

Keywords: high-mobility-group box 1; inflammation; ischemic stroke; white matter lesions.

Grants and funding

This study was supported in part by the Science and Technology Development Program of Suzhou (SYSD2018202), Jiangsu senile health research project (LSD2022019), the Science, Education, and Health Promotion Project in Wujiang District, Suzhou City (WWK201926).