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J Int Med Res. 2019 Feb 7:300060518819381. doi: 10.1177/0300060518819381. [Epub ahead of print]

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

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1 Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
2 Department of Respiratory Medicine, The Second People's Hospital of Qinzhou, Qinzhou, Guangxi, China.



To investigate the relationship between serum high mobility group box-1 protein (HMGB-1) levels and prognosis in patients with community-acquired pneumonia (CAP).


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.


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.


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.


C-reactive protein; High mobility group box-1 protein; clinical outcome; community-acquired pneumonia; cortisol; prognosis

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