[Association between high-mobility group box 1 and neonatal respiratory distress syndrome]

Value of serum NT proBNP, HMGB1, and SIRT1 in the diagnosis and prognosis of neonatal respiratory distress syndrome

Objective

To analyze the value of serum aminoterminal pro-brain natriuretic peptide (NT-proBNP), High mobility group protein B1(HMGB1), and silent information regulator factor 2 related enzyme 1 (SIRT1) in the diagnosis and prognosis of neonatal respiratory distress syndrome (NRDS).

Methods

This was a retrospective study. Eighty cases of NRDS infants were selected in Maternity & Child Care Center of Qinhuangdao from January 2022 to January 2024 as the study group, with 80 cases of normal newborns during the same period selected as the control group. The NRDS infants were divided into the excellent prognosis group (n=49) and the poor prognosis group (n=31). The levels of serum NT-proBNP, HMGB1, and SIRT1 were compared among the groups, along with an investigation of the value of these biomarkers for the diagnosis and prognosis of NRDS infants.

Results

The study group exhibited higher levels of serum NT-proBNP and HMGB1(P< 0.05) and lower levels of serum SIRT1(P< 0.05) than the control group. The ROC curve analysis suggested that AUC values for serum NT-proBNP, HMGB1, SIRT1, and their combination in the diagnosis of NRDS were 0.903, 0.829, 0.794, and 0.958, respectively. The ROC curve analysis showed that AUC values for serum NT-proBNP, HMGB1, SIRT1, and their combination in predicting poor prognosis in NRDS infants were 0.810, 0.813, 0.741, and 0.935, respectively.

Conclusion

The combination of serum NT-proBNP, HMGB1, and SIRT1 may demonstrate a high diagnostic value for NRDS infants, as well as a high predictive value for poor prognosis in such infants.

HMGB1: A Potential Target of Nervus Vagus Stimulation in Pediatric SARS-CoV-2-Induced ALI/ARDS

From the start of pandemics, children were described as the ones who were less affected by SARS-Cov-2 or COVID-19, which was mild in most of the cases. However, with the growing vaccination rate of the adult population, children became more exposed to the virus and more cases of severe SARS-CoV-2-induced ARDS are being diagnosed with the disabling consequences or lethal outcomes associated with the cytokine storm. Thus, we do hypothesize that some of the children could benefit from nervus vagus stimulation during COVID-19 ARDS through the inhibition of HMGB1 release and interaction with the receptor, resulting in decreased neutrophil accumulation, oxidative stress, and coagulopathy as well as lung vascular permeability. Moreover, stimulation through alpha-7 nicotinic acetylcholine receptors could boost macrophage phagocytosis and increase the clearance of DAMPs and PAMPs. Further rise of FGF10 could contribute to lung stem cell proliferation and potential regeneration of the injured lung. However, this stimulation should be very specific, timely, and of proper duration, as it could lead to such adverse effects as increased viral spread and systemic infection, especially in small children or infants due to specific pediatric immunity state and anatomical features of the respiratory system.

Efficacy comparison of high-frequency oscillatory ventilation with continuous nasal positive airway pressure in neonatal respiratory distress syndrome treatment

OBJECTIVES

To compare the treatment efficacy of high-frequency oscillatory ventilation (HFOV) with nasal continuous positive airway pressure (NCPAP) in the treatment of neonatal respiratory distress syndrome (NRDS) and its effect on the expression of high-mobility group protein B1 (HMGB1).

METHODS

A total of 180 infants with NRDS admitted to our hospital were included and randomly assigned into the HFOV group (receiving conventional therapy and HFOV), the NCPAP group (receiving conventional therapy and NCPAP), and the conventional group (receiving conventional therapy). Qi and blood indicators, heart rate, respiratory frequency, PCO₂, and PaO₂ were observed and recorded before and after treatment, together with complications after treatment. ELISA was performed for HMGB1 Results: A distinctly lower partial pressure of carbon dioxide (PCO₂) but higher arterial partial pressure of oxygen (PaO₂) was observed in the HFOV and NCPAP groups than in the conventional group (P < 0.05), whereas infants in the HFOV group exhibited slight differences in these two indicators from their counterparts in the NCPAP group (P > 0.05). The serum HMGB1 levels in both groups were significantly higher than those in the conventional group (P < 0.05).

DISCUSSION

Both HFOV and NCPAP are feasible in the treatment of NRDS and may play a role in the inhibition of HMGB1.