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High-mobility group box-1 and receptor for advanced glycation end products in preterm infants with brain injury 
High-mobility group box-1 and receptor for advanced glycation end products in preterm infants with brain injury
  Hong-Yan Lu, Jiang-Lin Ma, Ji-Yan Shan, Jie Zhang, Qiu-Xia Wang, Qiang Zhang
 [Abstract] [Full Text] [PDF]   Pageviews: 332 Times
Background: High-mobility group box-1 (HMGB1) protein acts as an important pro-inflammatory mediator, which is capable of activating inflammation and tissue repair. HMGB1 can bind to its receptor such as advanced glycation end products (RAGE). RAGE, in turn, can promote the production of pro-inflammatory cytokines. Soluble RAGE (sRAGE) is a truncated form of the receptor comprising the extracellular domain of RAGE and can inhibit RAGE-activation. The objective of this study was to investigate whether HMGB1 and RAGE are involved in the development of brain injury in preterm infants.
Methods: In total, 108 infants ¡Ü34 weeks gestation at birth were divided into 3 groups according to cranial ultrasound scan: mild brain damage (n=33), severe brain damage (n=8) and no brain damage (n=67). All the placentas were submitted for pathologic evaluation. Histological chorioamnionitis (HCA) was defined as neutrophil infiltration of amniotic membranes, umbilical cord or chorionic plate. Expressions of HMGB1 and RAGE proteins were assessed by immunohistochemical analysis. The concentration of HMGB1 and sRAGE in umbilical cord blood were measured by enzyme-linked immunosorbent assay.
Results: The frequency of HCA was 30.12%. HCA was associated with elevated concentrations of HMGB1 and decreased sRAGE in umbilical cord blood. The severe brain injury group demonstrated higher cord blood HMGB1 concentrations (P<0.001) and lower sRAGE concentrations (P<0.001) than both other groups. Brain injury in the premature infants was linked to intense staining for HMGB1/RAGE, particularly in inflammatory cells.
Conclusions: Changes of cord blood HMGB1 and sRAGE of premature infants had direct relationship with the degree of inflammation and severity of brain damage. Monitoring sRAGE and HMGB1 levels may be helpful to predict intrauterine infection and brain injury in premature infants.
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