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Abstrakt
Study of High Mobility Group Box 1 Values in Septic Disseminated Intravascular Coagulation Treated by Polymyxin-B Immobilized Fiber-Direct Hemoperfusion
Gaku Takahashi, Shigeatsu Endo and Yoshihiro Inoue
Background: High mobility group box 1 (HMGB1) is a pro-inflammatory cytokine that acts as a final -phase endotoxin mediator. HMGB1 also increases the expression of tissue factors in human peripheral blood monocytes, and induces DIC. We investigated HMGB1 values when polymyxin-B immobilized fiber-direct hemoperfusion (PMXDHP) was performed for the treatment of septic DIC patients with endotoxemia.
Methods: Serum high mobility group box 1 (HMGB1) levels were examined in 16 patients with septic disseminated intravascular coagulation (DIC) undergoing polymyxin-B-immobilized fiber-direct hemoperfusion (PMXDHP), whose serum endotoxin levels were ≥ 1.1 pg/mL and who exhibited shock symptoms.
Results: Average acute physiology and chronic health evaluation (APACHE II) score was 32.2, average sequential organ failure assessment (SOFA) score 12.4, and average DIC score 5.5. Following PMX-DHP, the serum endotoxin level decreased below the limit of detection in all the patients. The serum HMGB1 level significantly decreased and the DIC score improved on days 1 and 2 after PMX-DHP (P<0.05). There was a significant correlation between HMGB1 values and DIC score (P<0.05).
Conclusions: PMX-DHP was effective therapy for septic DIC and HMGB1 was a useful index for this clinical condition.