Diagnostic Value of High-Mobility Group Box 1 (HMGB1) Protein in Acute and Perforated Appendicitis

ABSTRACT

Aim: Acute appendicitis is the most common cause of abdominal surgical emergencies. Early diagnosis of appendicitis can reduce perforation and mortality rate. High-mobility group box 1 (HMGB1) protein has been identified as a pro-inflammatory factor and its elevated serum levels have been noted in different diseases. So, the aim of this study was to determine the serum levels of HMGB1 in patients with acute and perforated appendicitis in compare to normal appendix. Material and methods: For this purpose, serum samples were obtained from 81 patients with primary criteria-based appendicitis 6 hr before and 72 hr after appendectomy, in which serum levels of HMGB1 were analyzed by enzyme-linked immunosorbent assay. Results: The levels of HMGB1 in patients with perforated appendicitis were significantly (p =.045) higher than in patients with acute appendicitis and normal appendix (p =.001) before appendectomy. Serum levels of HMGB1 were increased 72 hr after appendectomy in all the groups (p =.03) compared with the serum levels before appendectomy. Conclusions: Since the serum levels of HMGB1 in patients with acute and perforated appendicitis were higher than in patients with normal appendix, these findings could be useful to develop a new biomarker along with other laboratory tests for accurate diagnosis of patients with appendicitis.

Keywords::

• appendicitis
• acute appendicitis
• ELISA method
• high-mobility group box 1
• perforated appendicitis
• surgery

Acknowledgments

The authors thank Dr. Mohammad Raffiee for statistical analysis of the data, and all the patients for participating in this study.

DECLARATION OF INTEREST

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.