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Thalassaemia major and infectious risk: High Mobility Group Box‐1 represents a novel diagnostic and prognostic biomarker
Author(s) -
Chirico Valeria,
Lacquaniti Antonio,
Piraino Basilia,
Cutrupi Maricia,
Cuppari Caterina,
Grasso Luisa,
Rigoli Luciana,
David Antonio,
Arrigo Teresa,
Salpietro Carmelo
Publication year - 2015
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.13530
Subject(s) - medicine , receiver operating characteristic , hmgb1 , hazard ratio , proportional hazards model , multivariate analysis , univariate analysis , biomarker , gastroenterology , area under the curve , confidence interval , biology , biochemistry , inflammation
Summary High mobility group box ‐1 ( HMGB 1) represents a common causal agent for various types of diseases, including infective pathologies. This study aimed to investigate the role of HMGB 1 in β‐thalassemia major ( TM ) by evaluating its diagnostic and prognostic role. Fifty‐one TM patients and 30 healthy subjects ( HS ) were enrolled. Receiver operating characteristics ( ROC ) analysis was employed to calculate the area under the curve ( AUC ) for HMGB 1 to determine the best cut‐off values capable of identifying infectious episodes. Adjusted risk estimates for infective events were calculated using univariate followed by multivariate Cox proportional hazard regression analysis. Serum HMGB 1 levels were higher in TM patients than in HS (14·6 ± 8·7 vs. 2·08 ± 0·9 ng/ml, P < 0·0001). Patients who underwent splenectomy were characterized by lower levels of HMGB 1, when compared with patients with an intact spleen (10·2 ± 8 vs. 19·1 ± 7 ng/ml, P = 0·004). ROC analyses revealed an AUC for serum HMGB 1 of 0·801, with a sensitivity and specificity of 92·3% and 68·2% to detect an infectious episode. Low HMGB 1 levels predicted high risk of infective events ( HR : 0·81; P = 0·006). HMGB 1 represents a prognostic marker for TM patients and a predictive factor for infectious events.