Prognostic value of plasma high mobility group box 1 protein and histone H3 levels in patients with disseminated intravascular coagulation: a multicenter prospective cohort study

Abstract

Background We compared the prognostic value of serum high mobility group box 1 protein (HMGB1) and histone H3 levels with the International Society on Thrombosis and Haemostasis (ISTH) disseminated intravascular coagulation (DIC) scores for 28-day in-hospital mortality in patients with DIC caused by various underlying diseases. Methods We conducted a multicenter prospective cohort study including two hematology departments, four emergency departments, and one general medicine department in Japan, between August 2017 and July 2021. We included patients diagnosed with DIC by the ISTH DIC scoring system. Results Overall, 104 patients were included: 50 with hematopoietic disorders, 41 with infections, and 13 with the other diseases. The 28-day in-hospital mortality rate was 21%. The receiver operator characteristic (ROC) curve showed that a DIC score of 6 points, serum HMGB1 level of 8 ng/mL, and serum histone H3 level of 2 ng/mL were the optimal cutoff points. The odds ratios of more than these optimal cutoff points of the DIC score, serum HMGB1, and histone H3 levels were 1.58 (95% confidence interval [CI]: 0.60 to 4.17, p = 0.36), 5.47 (95% CI: 1.70 to 17.6, p = 0.004), and 9.07 (95% CI: 2.00 to 41.3, p = 0.004), respectively. The area under the ROC curve of HMGB1 (0.74, 95% CI: 0.63 to 0.85) was better than that of the ISTH DIC scores (0.55, 95% CI: 0.43 to 0.67, p = 0.03), whereas that of histone H3 was not (0.71, 95% CI: 0.60 to 0.82, p = 0.07). Calibration and net reclassification plots of HMGB1 identified some high-risk patients, whereas the ISTH DIC scores and histone H3 did not. The category-free net reclassification improvement of HMGB1 was 0.45 (95% CI: 0.01 to 0.90, p = 0.04) and that of histone H3 was 0.37 (95% CI: − 0.05 to 0.78, p = 0.08). Conclusions Serum HMGB1 levels have a prognostic value for mortality in patients with DIC. This finding may help physicians develop treatment strategies.

Magnesium Sulfate Ameliorates Histone-Induced Coagulation Dysfunction and Lung Damage in Mice

“…To evaluate which biological processes of histones and Mg 2+ are involved in the pathogenesis of sepsis, bioinformatic analysis was performed (21). Putative targets associated with MgSO 4 and histones (main pathogenic types: H3 and H4 (5,22)) were harvested from the DrugBank, STITCH, or SuperPred databases. The targets in sepsis were used from web-based GeneCard and DisGeNET databases.…”

“…To evaluate which biological processes of histone and Mg 2+ are involved in the pathogenesis of sepsis. We determined the correlative targets of MgSO 4 , histones (main pathogenic types: H3 and H4 (5,22)), and sepsis through bioinformatics methods. Further Gene Ontology analysis showed that MgSO 4 may play an important part in histone-induced septic injury through coagulation-related biological process regulation (Fig.…”

Correction: Prognostic value of plasma high mobility group box 1 protein and histone H3 levels in patients with disseminated intravascular coagulation: a multicenter prospective cohort study

“…Author details 1 Department of Hematology, Fukushima Medical University, 1 Hikarigaoka, Fukushima 960-1295, Japan. 2 Scientific Research Works Peer Support Group (SRWS-PSG), Osaka, Japan.…”

“…Following publication of the original article [ 1 ], it was reported that the term ‘plasma’ should have been used in place of ‘serum’ in the title, abstract, methods, results, discussion, conclusions, and supplementaly information, and prior researches in reference number 11, 12, 13, and 15. It was also reported that the term ‘plasma or serum’ should have been used in place of ‘serum’ in a prior research in reference number nine.…”

“…It was also reported that the term ‘plasma or serum’ should have been used in place of ‘serum’ in a prior research in reference number nine. The original article [ 1 ] has been updated.…”