HMGB1 in nasal inflammatory diseases: a reappraisal 30 years after its discovery

ABSTRACT

Introduction

High mobility group protein box 1 (HMGB1) is a protein belonging to the alarmin family. HMGB1 has a relevant role in starting the inflammatory cascade by means of receptors, such as RAGE and TLR. HMGB1 supports transcription of many genes in interactions with many transcription factors, including NF-kB. The axis HMGB1-RAGE-NF-kB has, therefore, a pivotal role in the inflammatory cascade. HMGB1 controls the production of several pro-inflammatory cytokines and the proliferation and activation of many inflammatory cells.

Areas covered

The present report concerns the role of HMGB1 in nasal inflammatory disorders, including allergic and non-allergic rhinitis, and chronic rhinosinusitis with nasal polyps. HMGB1 modulation has been the aim of several studies. The literature search included recent papers that covered this topic.

Expert opinion

As HMGB1 has a pivotal role in inflammatory events, its modulation could be attractive for designing new therapeutic strategies. In this regard, glycyrrhetic acid (GA), the active component of Glycyrrhiza glabra, can efficiently block HMGB1. Promising reports seem to suggest that GA could exert favorable anti-inflammatory activity in patients with nasal inflammatory disorders.

KEYWORDS:

• HMGB1
• nasal inflammation
• allergic rhinitis
• chronic rhinosinusitis with nasal polyps
• glycyrrhetic acid

Article highlights

• HMGB1 is an alarmin involved in the inflammatory cascade. The axis HMGB1-RAGE-NF-kB controls the inflammatory cellular pathway and pro-inflammatory cytokines release.

• HMGB1 expression is increased in patients with nasal inflammatory diseases, including allergic rhinitis and chronic rhinosinusitis with nasal polyps.

• Glycyrrhetic acid (GA), the active component of Glycyrrhiza glabra, can efficiently block HMGB1.

• Preliminary in vivo studies demonstrated that GA reduced HMGB1 expression consistently with symptom improvement.

• HMGB1 modulation could be a new strategy in the management of nasal inflammatory disorders.

Declaration of interest

V Damiani is an employee of Drugs Minerals and Generics, Italy. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded