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

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.