High-Mobility Group Box-1 as a Predictor for Malignant Brain Edema Following Mechanical Thrombectomy in Acute Ischemic Stroke Patients

Xiao Chen,1,* Yan E,2,* Wei Wang,2 Yong Huang,1 Xueting Xin,1 Gang Chen1 1Department of Neurology, Haimen People’s Hospital, Nantong, Jiangsu, 226100, People’s Republic of China; 2Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, 2...

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Main Authors: Chen X, E Y, Wang W, Huang Y, Xin X, Chen G
Format: Article
Language:English
Published: Dove Medical Press 2025-06-01
Series:International Journal of General Medicine
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Online Access:https://www.dovepress.com/high-mobility-group-box-1-as-a-predictor-for-malignant-brain-edema-fol-peer-reviewed-fulltext-article-IJGM
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author Chen X
E Y
Wang W
Huang Y
Xin X
Chen G
author_facet Chen X
E Y
Wang W
Huang Y
Xin X
Chen G
author_sort Chen X
collection DOAJ
description Xiao Chen,1,* Yan E,2,* Wei Wang,2 Yong Huang,1 Xueting Xin,1 Gang Chen1 1Department of Neurology, Haimen People’s Hospital, Nantong, Jiangsu, 226100, People’s Republic of China; 2Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, 210000, People’s Republic of China*These authors contributed equally to this workCorrespondence: Gang Chen, Department of Neurology, Haimen People’s Hospital, No. 1201 Beijing Road, Nantong, Jiangsu Province, 226100, People’s Republic of China, Tel/Fax +86 051382263512, Email 15206283321@163.comBackground and Purpose: Emerging experimental evidence has established that high-mobility group box 1 (HMGB-1) plays a pivotal role in cerebral ischemia pathogenesis, primarily through mediating neuroinflammatory cascades following ischemic injury. This study sought to investigate the potential association between circulating HMGB-1 levels and the risk of malignant brain edema (MBE) in patients undergoing mechanical thrombectomy (MT).Methods: This study prospectively recruited patients presenting with large vessel occlusive stroke in the anterior circulation and receiving MT treatment. Serum HMGB-1 levels were quantitatively assessed for all participants upon hospital admission. MBE was defined as defined as a midline shift of ≥ 5 mm observed on follow-up neuroimaging after MT. Multivariate logistic regression analyses were conducted to investigate the potential correlation between serum HMGB-1 concentrations and MBE development.Results: Among the cohort of 261 eligible patients (mean age: 69.7 years; male: 166 [63.6%]), 59 individuals (22.6%; 95% confidence interval [CI]: 17.6%-28.3%) developed MBE. After adjusted for demographic characteristics and other potential confounders, multivariate logistic regression demonstrated that higher serum HMGB-1 levels were associated with an increased risk of MBE (odds ratios [OR], highest vs lowest quartile: 3.130; 95% CI, 1.077– 9.098; P = 0.036). In addition, restricted cubic spline analysis revealed a dose-response relationship between elevated serum HMGB-1 levels and MBE risk (P for non-linearity=0.764).Conclusion: This study confirmed that elevated circulating HMGB-1 levels were significantly associated with MBE after MT. These findings suggested that HMGB-1 could serve as a predictive biomarker for post-MT MBE risk, potentially enabling early identification of high-risk patients who may benefit from intensified monitoring or targeted therapeutic interventions.Keywords: HMGB-1, brain edema, endovascular treatment, ischemic stroke
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spelling doaj-art-d194a950598f4e289eb718b24e6f2e562025-08-20T03:29:49ZengDove Medical PressInternational Journal of General Medicine1178-70742025-06-01Volume 18Issue 133933400104184High-Mobility Group Box-1 as a Predictor for Malignant Brain Edema Following Mechanical Thrombectomy in Acute Ischemic Stroke PatientsChen XE Y0Wang W1Huang YXin XChen G2NeurologyNeurologyNeurologyXiao Chen,1,* Yan E,2,* Wei Wang,2 Yong Huang,1 Xueting Xin,1 Gang Chen1 1Department of Neurology, Haimen People’s Hospital, Nantong, Jiangsu, 226100, People’s Republic of China; 2Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, 210000, People’s Republic of China*These authors contributed equally to this workCorrespondence: Gang Chen, Department of Neurology, Haimen People’s Hospital, No. 1201 Beijing Road, Nantong, Jiangsu Province, 226100, People’s Republic of China, Tel/Fax +86 051382263512, Email 15206283321@163.comBackground and Purpose: Emerging experimental evidence has established that high-mobility group box 1 (HMGB-1) plays a pivotal role in cerebral ischemia pathogenesis, primarily through mediating neuroinflammatory cascades following ischemic injury. This study sought to investigate the potential association between circulating HMGB-1 levels and the risk of malignant brain edema (MBE) in patients undergoing mechanical thrombectomy (MT).Methods: This study prospectively recruited patients presenting with large vessel occlusive stroke in the anterior circulation and receiving MT treatment. Serum HMGB-1 levels were quantitatively assessed for all participants upon hospital admission. MBE was defined as defined as a midline shift of ≥ 5 mm observed on follow-up neuroimaging after MT. Multivariate logistic regression analyses were conducted to investigate the potential correlation between serum HMGB-1 concentrations and MBE development.Results: Among the cohort of 261 eligible patients (mean age: 69.7 years; male: 166 [63.6%]), 59 individuals (22.6%; 95% confidence interval [CI]: 17.6%-28.3%) developed MBE. After adjusted for demographic characteristics and other potential confounders, multivariate logistic regression demonstrated that higher serum HMGB-1 levels were associated with an increased risk of MBE (odds ratios [OR], highest vs lowest quartile: 3.130; 95% CI, 1.077– 9.098; P = 0.036). In addition, restricted cubic spline analysis revealed a dose-response relationship between elevated serum HMGB-1 levels and MBE risk (P for non-linearity=0.764).Conclusion: This study confirmed that elevated circulating HMGB-1 levels were significantly associated with MBE after MT. These findings suggested that HMGB-1 could serve as a predictive biomarker for post-MT MBE risk, potentially enabling early identification of high-risk patients who may benefit from intensified monitoring or targeted therapeutic interventions.Keywords: HMGB-1, brain edema, endovascular treatment, ischemic strokehttps://www.dovepress.com/high-mobility-group-box-1-as-a-predictor-for-malignant-brain-edema-fol-peer-reviewed-fulltext-article-IJGMHMGB-1brain edemaendovascular treatmentischemic stroke
spellingShingle Chen X
E Y
Wang W
Huang Y
Xin X
Chen G
High-Mobility Group Box-1 as a Predictor for Malignant Brain Edema Following Mechanical Thrombectomy in Acute Ischemic Stroke Patients
International Journal of General Medicine
HMGB-1
brain edema
endovascular treatment
ischemic stroke
title High-Mobility Group Box-1 as a Predictor for Malignant Brain Edema Following Mechanical Thrombectomy in Acute Ischemic Stroke Patients
title_full High-Mobility Group Box-1 as a Predictor for Malignant Brain Edema Following Mechanical Thrombectomy in Acute Ischemic Stroke Patients
title_fullStr High-Mobility Group Box-1 as a Predictor for Malignant Brain Edema Following Mechanical Thrombectomy in Acute Ischemic Stroke Patients
title_full_unstemmed High-Mobility Group Box-1 as a Predictor for Malignant Brain Edema Following Mechanical Thrombectomy in Acute Ischemic Stroke Patients
title_short High-Mobility Group Box-1 as a Predictor for Malignant Brain Edema Following Mechanical Thrombectomy in Acute Ischemic Stroke Patients
title_sort high mobility group box 1 as a predictor for malignant brain edema following mechanical thrombectomy in acute ischemic stroke patients
topic HMGB-1
brain edema
endovascular treatment
ischemic stroke
url https://www.dovepress.com/high-mobility-group-box-1-as-a-predictor-for-malignant-brain-edema-fol-peer-reviewed-fulltext-article-IJGM
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