A recent study highlights the prognostic value of serum High-Mobility Group Box 1 (HMGB1) in neonates with neonatal encephalopathy (NE), providing new insights into early risk stratification in this vulnerable population.
This investigation analyzed 216 neonates diagnosed with NE, categorizing them based on 28-day outcomes into good prognosis (n = 174) and poor prognosis (n = 42) groups. The serum HMGB1 levels, measured within the first 24 hours of birth, were significantly higher in neonates with poor outcomes.
- Elevated serum HMGB1 (> 6.14 ng/mL) was identified as an independent risk factor for adverse outcomes.
- Other predictors included extreme #prematurity, extremely low birth weight, low Apgar score at 5 minutes (0–3), maternal premature rupture of membranes, and moderate-to-severe NE.
- Receiver Operating Characteristic (ROC) analysis revealed an AUC of 0.79, highlighting the moderate-to-strong predictive capacity of HMGB1 for short-term prognosis.
A decrease in HMGB1 levels over time was associated with favorable neurological outcomes. Conversely, persistently elevated or rising HMGB1 levels suggested ongoing neuroinflammatory processes and worse prognosis.
Damage-associated molecular pattern
HMGB1 is a nuclear protein that, upon release into the extracellular space—typically during cell damage or stress—acts as a damage-associated molecular pattern (DAMP). In the context of NE, HMGB1 amplifies the neuroinflammatory response, contributing to secondary brain injury.
The early measurement of serum HMGB1 presents a promising avenue for the prognostic evaluation of neonates with encephalopathy, offering both clinical and research applications. Its integration into early screening could improve stratification, guide therapeutic strategies, and ultimately enhance outcomes in this high-risk population.
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