DOI
https://doi.org/10.18849/ve.v11i3.741Abstract
PICO Question
In canine patients with infectious systemic inflammatory response syndrome (SIRS), how do increased levels of High Mobility Group Box 1 (HMGB1) protein, compared to low levels, relate to mortality outcomes?
Clinical bottom line
Category of research
Prognosis.
Number and type of study designs reviewed
Three studies were critically reviewed. All three studies were prospective observational studies.
Strength of evidence
Weak.
Outcomes reported
All three studies included in this Knowledge Summary evaluated canine patients with SIRS, encompassing both infectious and non-infectious causes. The second and third paper both found a significant association between elevated serum HMGB1 levels and increased mortality in dogs with SIRS. The first paper, while focusing specifically on infectious SIRS, did not find a statistically significant correlation between HMGB1 levels and mortality, although HMGB1 levels were elevated in SIRS cases compared to healthy controls. Variability in the timing of HMGB1 measurements, along with differences in study design, population heterogeneity, and small sample sizes, may have contributed to inconsistencies in the findings. Overall, the evidence suggests a potential association between higher HMGB1 levels and increased mortality in dogs with SIRS, but further standardised research is needed to strengthen this conclusion.
Conclusion
While two studies identified an association between elevated HMGB1 and mortality, the findings are inconclusive. The strength of evidence is restricted by diagnostic and methodological limitations, making for weak quality evidence overall. Future research should prioritise standardised measurement timing, larger and more homogeneous populations, and explore HMGB1’s role in disease progression to fully establish its utility as a prognostic marker in canine SIRS.
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