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Review

Targeting High Mobility Group Box 1 in Subarachnoid Hemorrhage: A Systematic Review

1
Department of Neurosurgery, Heinrich-Heine University Medical Center, 40225 Düsseldorf, Germany
2
Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, 00014 Helsinki, Finland
3
Shifa College of Pharmaceutical Sciences, Shifa Tameer-e-Millat University, Islamabad 44000, Pakistan
*
Author to whom correspondence should be addressed.
Int. J. Mol. Sci. 2020, 21(8), 2709; https://0-doi-org.brum.beds.ac.uk/10.3390/ijms21082709
Received: 19 March 2020 / Revised: 10 April 2020 / Accepted: 11 April 2020 / Published: 14 April 2020
(This article belongs to the Special Issue HMG Proteins in Development and Disease)
Aneurysmal subarachnoid hemorrhage (aSAH) is a complex and potentially deadly disease. Neurosurgical clipping or endovascular coiling can successfully obliterate ruptured aneurysms in almost every case. However, despite successful interventions, the clinical outcomes of aSAH patients are often poor. The reasons for poor outcomes are numerous, including cerebral vasospasm (CVS), post-hemorrhagic hydrocephalus, systemic infections and delayed cerebral ischemia. Although CVS with subsequent cerebral ischemia is one of the main contributors to brain damage after aSAH, little is known about the underlying molecular mechanisms of brain damage. This review emphasizes the importance of pharmacological interventions targeting high mobility group box 1 (HMGB1)-mediated brain damage after subarachnoid hemorrhage (SAH) and CVS. We searched Pubmed, Ovid medline and Scopus for “subarachnoid hemorrhage” in combination with “HMGB1”. Based on these criteria, a total of 31 articles were retrieved. After excluding duplicates and selecting the relevant references from the retrieved articles, eight publications were selected for the review of the pharmacological interventions targeting HMGB1 in SAH. Damaged central nervous system cells release damage-associated molecular pattern molecules (DAMPs) that are important for initiating, driving and sustaining the inflammatory response following an aSAH. The discussed evidence suggested that HMGB1, an important DAMP, contributes to brain damage during early brain injury and also to the development of CVS during the late phase. Different pharmacological interventions employing natural compounds with HMGB1-antagonizing activity, antibody targeting of HMGB1 or scavenging HMGB1 by soluble receptors for advanced glycation end products (sRAGE), have been shown to dampen the inflammation mediated brain damage and protect against CVS. The experimental data suggest that HMGB1 inhibition is a promising strategy to reduce aSAH-related brain damage and CVS. Clinical studies are needed to validate these findings that may lead to the development of potential treatment options that are much needed in aSAH. View Full-Text
Keywords: subarachnoid hemorrhage; damage-associated molecular pattern molecules (DAMPs); alarmins; HMGB1 (High mobility group box 1); CVS (Cerebral vasospasm) subarachnoid hemorrhage; damage-associated molecular pattern molecules (DAMPs); alarmins; HMGB1 (High mobility group box 1); CVS (Cerebral vasospasm)
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MDPI and ACS Style

Muhammad, S.; Chaudhry, S.R.; Kahlert, U.D.; Lehecka, M.; Korja, M.; Niemelä, M.; Hänggi, D. Targeting High Mobility Group Box 1 in Subarachnoid Hemorrhage: A Systematic Review. Int. J. Mol. Sci. 2020, 21, 2709. https://0-doi-org.brum.beds.ac.uk/10.3390/ijms21082709

AMA Style

Muhammad S, Chaudhry SR, Kahlert UD, Lehecka M, Korja M, Niemelä M, Hänggi D. Targeting High Mobility Group Box 1 in Subarachnoid Hemorrhage: A Systematic Review. International Journal of Molecular Sciences. 2020; 21(8):2709. https://0-doi-org.brum.beds.ac.uk/10.3390/ijms21082709

Chicago/Turabian Style

Muhammad, Sajjad, Shafqat R. Chaudhry, Ulf D. Kahlert, Martin Lehecka, Miikka Korja, Mika Niemelä, and Daniel Hänggi. 2020. "Targeting High Mobility Group Box 1 in Subarachnoid Hemorrhage: A Systematic Review" International Journal of Molecular Sciences 21, no. 8: 2709. https://0-doi-org.brum.beds.ac.uk/10.3390/ijms21082709

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