Özet:

High mobility group box-1 protein (HMGB-1) acts as a potent pro-inflammatory cytokine that is actively secreted by innate immune cells and/or passively released by injured or damaged cells during the terminal phase of sepsis. Therefore, serum and tissue levels of HMGB1 are elevated during infection, especially during sepsis. In this study, we aimed to evaluate HMGB1 levels in neonatal sepsis and its association with septic shock and death. Fifty-three neonates with a clinical or proven diagnosis of sepsis were included in the study. Fifty-seven postnatal age-matched neonates without symptoms or signs of infection and receiving routine NICU care were included as controls. Twelve patients had proven sepsis and 6 patients had septic shock. The death occurred in five septic infants. HMGB1 levels were higher in neonates with sepsis compared with controls; patients with septic shock had higher HMGB1 levels compared with those without septic shock (p=0.002). Although non-survivors had higher HMGB1 levels compared to survivors, this was not statistically significant (p=0.086). HMGB1 levels decreased significantly three days after diagnosis in patients without septic shock (p=0.014) but remained elevated in patients with septic shock (p=0.465). A positive correlation was found between CRP and HMGB1 (p=0.008, r=0.252). HMGB1 is a sensitive marker for differentiating patients with sepsis from the non-septic group. The addition of HMGB1 to the group of inflammatory markers may be useful in the detection of patients with severe sepsis compared to the diagnosis of sepsis.

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