Expression of high mobility group box 1 protein in patients with ankylosing spondylitis / 中华风湿病学杂志

ABSTRACT

Objective To investigate the role of high mobility group box l protein (HMGB1) in the pathogenesis of ankylosing spondylitis (AS). Methods Enzyme-linked immuno sorbent assay (ELISA) was used to test the levels of plasma HMGB1 levels in 58 patients with active AS [bath ankylosing spondylitis disease activity index (BASDAI)>6, or 6>BASDAI>4 and erythrocyte sedimentation rate (ESR)>22 mm/1 h, 6>BASDAI>4 and hypersensitive C reactive protein (hsCRP)>9 mg/L], 73 cases of stable AS (BASDAI<4) and 70 healthy control. Twelve patients who were treated with TNF-alpha antagonist for 6 month were followed-up. Their plasma levels of HMGB1 were detected before and after treatment. Quantitative data were described by, while qualitative data were described by case number. Variance analysis or rank sum test was adopted for the difference between measurement data groups, LSD method was adopted for further pair-wise comparison. The correlation between variables was analyzed by using Spearman correlation analysis. Results The levels of plasma HMGB1, ESR, hsCRP, White blood cell WBC, GR, Mo and GLOB were significantly higher in the AS patients than those in the healthy control group (P<0.001), and the level of plasma HMGB1 in the AS patients was significantly positively correlated with BASDAI, Bath ankylosing spondylitis functional index (BASFI), ESR, hsCRP, WBC, GR, Mo, and GLOB (r=0.288, 0.174, 0.308, 0.243, 0.261, 0.301, 0.279, 0.289; P=0.004, 0.047, 0.000, 0.005, 0.003, 0.000, 0.001 ,0.001). The level of plasma HMGB1, BASDAI, BASFI, ESR, hsCRP, WBC, GR, GLOB were significantly higher in the active AS group than in the stable group (Z=-3.598,-9.456,-5.907, -2.562, -3.178, 4.134, -2.574, -4.582; P=0.000, 0.000, 0.000, 0.012, 0.002, 0.000, 0.011, 0.000). The level of plasma HMGB1 was not found statistically poor in the patients with different expressions of HLA-B27, or hip involvement and history of vuvitis (P>0.05). The plasma HMGB1 level, BASDAI, BAIFI, ESR, hsCRP and GLOB in the 12 followed-up patients were significantly decreased (P=0.034, 0.002, 0.002, 0.005, 0.004, 0.004) after being treated with biological agents for 6 months. Conclusion HMGB1 might play a vital role in the pathogenesis of ankylosing spondylitis,and the HMGB1 might be used as a clinical indicator to evaluate the activity of AS and to assess the clinical efficacy.