The serum high-mobility group box 1 level and RAGE expression in childhood acute lymphoblastic leukemic patients’

Introduction High-mobility group box 1 (HMGB1) overexpression renders cancer cells resistant to apoptosis, and plays an important role in chemotherapy resistance. The aim of the present study was to measure serum high-mobility group box 1 (sHMGB1) and its receptor expression, advanced glycation end (RAGE) on childhood acute lymphoblastic leukemia (ALL) blast cells, and their correlation with different variables. Participants and methods Twenty-eight newly diagnosed childhood ALL cases (group I), 24 patients with childhood ALL in complete remission (group II), and 22 apparently normal individuals matched for age and sex as the control group (group III) were included in the study. In addition to routine laboratory investigations, sHMGB1 was measured by enzyme-linked immunosorbent assay, and RAGE expression on mononuclear cells from the bone marrow and/or the peripheral blood was assessed using monoclonal antibodies by flow cytometry for all participants. Results sHMGB1 and RAGE expression were significantly higher in ALL (group I) when compared with other groups; there was no significant difference between groups II and III with regard to sHMGB1 and RAGE expression. There were significant positive correlations between sHMGB1 and the white blood cell count and the bone marrow blast percentage in group I, and no significant correlations were found between sHMGB1, the RAGE expression, and other variables. Conclusion The present study showed significant upregulation of sHMGB1 in all cases and RAGE expression in a few cases of childhood ALL. HMGB1 may represent an important potential target for cancer therapeutics. Hence, we recommend the concomitant use of HMGB1-neutralizing antibodies and potential HMGB1 release inhibitors (e.g. quercetin) with the chemotherapeutic agents used in childhood ALL treatment.