High Mobility Group Box Protein 1, Sterile Inflammatory Molecules: Motential Biomarkers for Preeclampsia: Human Study

Background and Aim: Pre-eclampsia (PE) is a rare but serious hypertensive disorder during pregnancy, affecting 5–8% of pregnant women globally. Current prognostic criteria rely on latestage indicators, including elevated blood pressure, edema, protein urea, and various biomarkers. The absence of clinical signs of inflammation in PE patients poses a challenge. This hypothesis suggests that specific signaling molecules, particularly HMGB1, could serve as early predictive markers for PE.
Materials and Methods: Blood was collected from non-pregnant, pregnant and pregnant women with confirmed PE and after recovery (n=60/gr; aged 20-45 years) as per ACOG criteria. Plasma was separated and circulating nucleic acids (CANs) and SI molecules were assayed.
Results: CANs [i.e. eRNA (3.0 fold); eDNA (1.5 fold)] were significantly (p<0.05) up-regulated in women with symptomatic PE when compared to pregnancy with no PE as well as normal control subjects. A significantly higher level of HMGB1 (2.5 fold); vWF (1.5 fold), S100b (1.0 fold), IL6 (1.0 fold) & Decorine (3.0 fold) (p<0.5) in women was shown with symptomatic PE compared to control. The neutrophil-lymphocyte ratio (NLR) was significantly higher in PE patients compared to control (p<0.5). However, the expression of all the markers returned to normal after recovery from PE. Immunoflurocent study showed a higher level of HMGB1 and Decorin expression in PE
in a co-localized manner. ROC and AUC analysis showed that HMGB1 significantly higher rate (99.3%) of predictability and sensitivity as a marker in compared to Decorine (96.5%) & eDNA (85.4%).
Conclusion: HMGB1 could be a predictive bio-markers for early detection for PE with greater sensitivity.