Plasma High-Mobility Group Box-1 and Galectin-9 in Patients with Trauma and Their Prognostic Potentials

Plasma High-Mobility Group Box-1 and Galectin-9 in Patients with Trauma and Their Prognostic Potentials

Toshiro Niki,¹ Haorile Chagan-Yasutan,^2,3 Daisuke Furushima,^4,5 Toshio Hattori,^2,6 Yugo Ashino,^7,8 Satoshi Yamanouchi^9,10 and Shigeki Kushimoto¹¹

¹Department of Immunology, Faculty of Medicine, Kagawa University, Kita-gun, Kagawa, Japan
²International Research Institute of Disaster Science, Tohoku University, Sendai, Miyagi, Japan
³Mongolian Psychosomatic Medicine Department, International Mongolian Medicine Hospital of Inner Mongolia, Hohhot, China
⁴Department of Public Health, Graduate School of Medical Science, Tokyo Women’s Medical University, Tokyo, Japan
⁵Graduate School of Health Science, Kagoshima University, Kagoshima, Japan
⁶Shizuoka Graduate University of Public Health, Shizuoka, Japan
⁷Department of Internal Medicine, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan
⁸Department of Respiratory Medicine, Sendai City Hospital, Sendai, Miyagi, Japan
⁹Department of Emergency and Critical Care Medicine/Emergency Center, Tohoku University Hospital, Sendai, Miyagi, Japan
¹⁰Emergency and Critical Care Department, Sendai City Hospital, Sendai, Miyagi, Japan
¹¹Division of Emergency and Critical Care Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan

Damage-associated molecular patterns (DAMPs) are endogenous molecules released from damaged tissues and elicit strong inflammatory responses of the host. Hence, they are supposed to play essential roles in the disrupted immune homeostasis after traumatic injuries. We examined plasma levels of galectin-9 (Gal-9), an immune checkpoint molecule as well as a DAMP, and a representative DAMP, high-mobility group box-1 (HMGB-1) in the trauma patient. Gal-9 was very high at admission, declined swiftly, and reached the normal level in 48 hours, while HMGB-1 was highest at admission, declined in 24 hours, then stagnated through the assessment period of 7 days with a level much higher than that of healthy subjects. The concentration of these DAMPs at admission correlated well with each other. HMGB-1 correlated with 6 prognostic parameters compared to only 2 for Gal-9, which reflects HMGB-1 but not Gal-9 could discriminate between survived and deceased patients. Receiver-operating characteristic (ROC) curve analysis demonstrated that plasma HMGB-1 possesses a moderate prognostic potential to discriminate deceased patients from survivors. Collectively, HMGB-1 has a potential to make a valuable blood biomarker for trauma, possibly in combination with other blood biomarkers.

Key words —— damage-associated molecular pattern; galectin-9; high-mobility group box-1; prognosis; trauma

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Tohoku J. Exp. Med., 2025 April, 265(4), 261-269.

Correspondence: Satoshi Yamanouchi, Emergency and Critical Care Department, Sendai City Hospital, Sendai, Miyagi 982-8502, Japan.

e-mail: yamanouchi-sat@hospital.city.sendai.jp