Mahmoud Amini - Department of Surgery, School of Medicine, Arak University of Medical Sciences, Arak, Iran.
Abdolali Pakdaman - Department of Surgery, School of Medicine, Arak University of Medical Sciences, Arak, Iran.
Shima Shapoori - Department of Immunology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Ghasem Mosayebi - Molecular and Medicine Research Center, Department of Immunology, School of Medicine, Arak University of Medical Sciences, Arak, Iran.

Background: Acute cholecystitis is defined as gallbladder inflammation caused by obstruction of the cystic duct. The pro-inflammatory cytokine, high mobility group box-1 (HMGB1), has been found to hold critical roles in the pathogenesis of several different inflammatory diseases. This study aimed to determine the relationship between HMGB1 and acute cholecystitis, and examine the potential for this cytokine as a biomarker for clinical diagnosis. Methods: The serum of 23 patients with severe acute cholecystitis, 45 patients with mild acute cholecystitis and 35 healthy subjects was collected and isolated from peripheral blood. The serum levels of HMGB1, CRP, amylase, lipase and the number of white blood cells were measured prior to the patient’s cholecystectomy and 48 hours following the procedure. Results: A significant increase in the levels of HMGB1 were observed in both patient groups with mild or severe acute cholecystitis compared with normal group. ROC analysis determined a cut-off point of 2.34 for HMGB1 serum levels to discriminate between the normal group and acute cholecystitis patients with a sensitivity of 79.41% and a specificity of 54.3%. The area under the ROC curve was 0.71. Furthermore, a positive correlation was observed between CRP and HMGB1 levels and no significant difference in the levels of amylase and lipase was observed between groups. Conclusions: These findings suggest a potential role for HMGB1 as an effective biomarker in improving the diagnostic accuracy of acute cholecystitis when used in conjunction with the standard diagnostic tests.

Cholecystitis, C- reactive protein, High mobility group box-1, Inflammation.