High mobility protein group box-1 as a biomarker for prediction of severity and clinical outcome of ischemic stroke: preliminary findings

Abstract

Abstract Background High Mobility Group Box 1 protein functions as a danger-associated molecular pattern and is crucial in the pathophysiology of ischemic damage and ensuing inflammatory responses. Objective To assess the role of HMGB1 as a biomarker for evaluation of the severity and clinical outcome of ischemic stroke. Subjects and methods The study participants were split into two categories: Case group (30) and Control group (30). Every participant underwent a medical history review, along with general and neurological evaluations. All patients were categorized according to The TOAST classification and assessed using the NIHSS and The modified Rankin Scale (mRS). The laboratory evaluation included the assessment of HMGB-1 levels. The radiological evaluation included CT brain, MRI brain, and carotid duplex. Results The levels of HMGB-1 were significantly higher in cases of ischemic stroke compared to controls ( P < 0.001). A substantial rise in HMGB-1 levels was observed from mild to severe stroke. Patients with poor mRS showed a notable rise in HMGB-1 levels compared to those with good mRS ( P = 0.005). HMGB-1 can forecast ischemic stroke with a cutoff above 129.8. The Receiver Operating Characteristic (ROC) curve indicated that HMGB-1 can forecast ischemic stroke at a threshold exceeding 129.8. A cut-off value exceeding 247.3 of HMGB-1 demonstrated considerable predictive capability for adverse outcomes in stroke patients, yielding an AUC of 0.787 for HMGB-1 ( P < 0.001). Conclusion HMGB-1 has a potential role as a biomarker for prediction of severity and functional outcome of ischemic stroke.