目的:先前的研究表明,高迁移率族蛋白B1(HMGB1)水平在先兆子痫(PE)中升高。然而,结论仍有争议。本研究旨在探讨孕妇血液和胎盘HMGB1水平与PE的关系。
方法:经过系统的文献检索,根据纳入和排除标准筛选符合条件的文献.数据提取和质量评估由两名审阅者独立进行。使用ReviewManager5.4和STATA12.0软件分析提取的数据。进行亚组分析和荟萃回归分析以寻找异质性的潜在来源。
结果:纳入了12项研究,共有1145名参与者。与正常妊娠相比,妊娠合并PE的孕妇血液HMGB1水平显著升高(SMD=1.34,95%CI:0.72-1.95,p<0.0001).同样,通过Westernblot(MD=0.37,95%CI:0.27-0.47,p<0.00001)或免疫组织化学(OR=6.36,95%CI:1.48-27.25,p=0.01),PE中胎盘HMGB1的表达高于正常对照组。此外,血HMGB1水平与PE严重程度呈正相关,重度PE中血HMGB1水平高于轻度PE(SMD=3.35,95%CI:0.63-6.06,p=0.02)。亚组分析显示亚洲组血液HMGB1与PE密切相关,但不是在欧洲集团。
结论:PE患者血液和胎盘HMGB1水平均显著升高,较高的血液HMGB1水平表明疾病状况更严重,提示较高的HMGB1水平与PE风险相关。
OBJECTIVE: Previous studies had demonstrated that high-mobility group box 1 (
HMGB1) levels were elevated in preeclampsia (PE). However, the conclusion remains controversial. This study aimed to investigate the association between blood and placenta
HMGB1 levels and PE in pregnant women.
METHODS: After a systematic literature search, eligible literature was screened according to inclusion and exclusion criteria. Data extraction and quality assessment were performed independently by two reviewers. The extracted data were analyzed using
Review Manager 5.4 and STATA 12.0 software. Subgroup analysis and meta-regression analysis were conducted to find potential sources of heterogeneity.
RESULTS: Twelve studies were included, with a total of 1145 participants. Compared with normal pregnancies, pregnant women with PE had significantly higher blood HMGB1 levels (SMD = 1.34, 95% CI: 0.72-1.95, p < 0.0001). Similarly, the expression of placental HMGB1 in PE was higher than that in normal controls by using Western blot (MD = 0.37, 95% CI: 0.27-0.47, p < 0.00001) or immunohistochemistry (OR = 6.36, 95% CI: 1.48-27.25, p = 0.01). In addition, the blood HMGB1 levels were positively correlated with the severity of PE, with higher blood
HMGB1 levels in severe PE than those in mild PE (SMD = 3.35, 95% CI: 0.63-6.06, p = 0.02). The subgroup analysis indicated a close association of blood HMGB1 with PE in the Asian group, but not in the European group.
CONCLUSIONS: Both blood and placental HMGB1 levels in patients with PE were significantly elevated, and higher blood HMGB1 levels indicated a more serious disease condition, suggesting that higher levels of
HMGB1 were associated with the risk of PE.