Correlation analysis of serum HMGB1 with clinical indicators in children with sepsis

Background Sepsis is a dysregulated bodily response, and high mobility group box 1 (HMGB1) acts as a pro-inflammatory mediator of its pathogenesis. However, the association between HMGB1 and complications or clinical indicators in pediatric sepsis patients remain incompletely understood. Methods Children aged 1 month − 18 years admitted to our hospital (March 2022 - December 2023) with a discharge diagnosis of sepsis were enrolled. Correlation analysis was performed to explore the relationship between HMGB1 levels and general information, clinical characteristics, and laboratory results. Additionally, HMGB1-related immune infiltration was analyzed via the CIBERSORT algorithm using peripheral blood transcriptome data of pediatric sepsis from the GEO database. Results A total of 90 sepsis patients and 21 healthy controls were included. Compared with the control group, the sepsis group presented greater body temperature and serum HMGB1 levels (P < 0.05). HMGB1 was positively correlated with PCT, IL-6, the organ involvement count, D-dimer, the neutrophil percentage, lactate, and blood ammonia (P < 0.05) and negatively correlated with the CD3 + CD4 + T-cell percentage (P < 0.05). Moreover, HMGB1 expression was inversely correlated with regulatory T cells (Tregs) and naïve CD4 + T cells but positively correlated with resting and activated CD4 memory T cells. Conclusion Serum HMGB1 is significantly elevated in pediatric sepsis patients and closely associated with organ dysfunction, coagulation disorders, increased inflammatory markers, and immune dysfunction. The underlying mechanisms warrant further investigation.