High mobility group box 1 serum levels are increased in Behçet’s disease, but not associated with disease activity or disease manifestations

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Objectives. High mobility group box 1 (HMGB1) is a nuclear protein that acts as an alarmin when released into the extracellular milieu. HMGB1 is a biomarker of active disease in several systemic autoimmune diseases. Behçet’s disease (BD) is a systemic inflammatory disorder with a waxing/waning course. The objective of this study is to evaluate serum HMGB1 levels as a possible biomarker for disease activity in BD.

Methods. A cross-sectional study measuring serum HMGB1 levels was performed in 26 BD patients and 20 healthy controls. The Brazilian version of the simplified BD Current Activity Form (BR-BDCAFs) was used to measure disease activity.

Results. Serum HMGB1 levels were higher in patients with active disease [3.82 (2.54–6.11) ng/ml], in patients with BD without active disease but still on therapy [2.76 (1.89–5.78) ng/ml] and in patients in remission without treatment [2.66 (1.86–4.70) ng/ml] than in healthy controls [0.96 (0.59–1.39) ng/ml], P < 0.001. Levels were comparable between BD patients with active disease, BD without active disease but still on therapy and those in remission without treatment (P = 0.432). There was no correlation between serum HMGB1 levels and BR-BDCAF(s) (ρ = 0.195; P = 0.339). No association could be found between serum HMGB1 levels and specific disease involvement or therapy. So serum HMGB1 levels cannot be used as a biomarker in BD.

Conclusion. Serum HMGB1 levels are increased in patients with BD as compared with healthy controls. However, no association was found with disease activity, specific organ involvement or therapy in BD.

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