Evaluation of HMGB1 levels in children with coeliac disease

ESPGHAN 54th Annual Meeting, Kobenhavn, Danimarka, 22 - 25 Haziran 2022, cilt.74, ss.135

GASTROENTEROLOGY - Coeliac disease

G-P-013

Y. Aydemir1, M. Yagci2, Z. Baris1

1Eskisehir Osmangazi University, Pediatric Gastroenterology and Hepatology, Eskisehir,

Turkey, 2Eskisehir Osmangazi University, Pediatrics, Eskisehir, Turkey

Objectives and Study: High Mobility Group Box-1 (HMGB-1), a cytokine secreted by necrotic cells

and activated macrophages, contributes to initiation of the inflammatory process in Coeliac disease

(CD). The HMGB-1 may show the degree of severity of mucosal injury in patients with CD. We aimed

to evaluate the relationship between HMGB-1 levels and clinical, laboratory, and histopathological

findings of paediatric patients with CD.

Methods: Patients aged 2-18 years were included in the study. The study comprised age and sex

matched 3 groups: patients with newly diagnosed CD (group 1, n=36), coeliac patients in remission

(group 2, n=36), and a healthy control group (group 3, n=36). Patients with intestinal pathologies,

inflammatory and/or autoimmune diseases were excluded. Serum sample was stored at -20 ˚C until

the HMGB-1 levels were studied.

Results: The mean age was 9.41±3.90 years in the group 1, 9.91±3.36 years in group 2, and

9.56±4.00 years in group 3. There was no statistically significant difference between the groups in

terms of age (p=0.844). The HMGB-1 level was significantly higher in the group 1 when compared to

the groups 2 and 3 (p=0.028 and p=0.012, respectively). However, the levels of HMGB-1 were

statistically similar between groups 2 and 3. HMGB-1 levels in group 1 were significantly lower in

patients with a Marsh score of type 3a and type 3b when compared to patients with a Marsh score of

type 3c (p=0.009 and p=0.065, respectively). Similarly, HMGB-1 levels in patients with a tissue

transglutaminase Ig A (TTG IgA) level less than 10x the upper limit of normal were significantly lower

than in patients with a TTG IgA greater than 10x the upper limit of normal (p=0.03) in group 1.

Likewise, HMGB-1 levels positively correlated with the increased levels of anti-endomysium IgA (EMA

IgA) antibody levels (p=0.001).

Conclusions: In conclusion, HMGB-1 has a good correlation with levels of DTG-Ig A, EMA IgA and

degree of mucosal atrophy in patients with CD. However, further studies are needed to evaluate its

value in CD.