CC-BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2017; 21(04): 390-398
DOI: 10.1055/s-0036-1597665
Systematic Review
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

HMGB1 in the Pathogenesis of Nasal Inflammatory Diseases and its Inhibition as New Therapeutic Approach: A Review from the Literature

Luisa Maria Bellussi
1  ENT Department, University of Siena, Siena, Italy
Serena Cocca
1  ENT Department, University of Siena, Siena, Italy
Giulio Cesare Passali
2  ENT Department, Sacred Heart University, Rome, Italy
Desideri Passali
1  ENT Department, University of Siena, Siena, Italy
› Author Affiliations
Further Information

Publication History

28 June 2016

31 October 2016

Publication Date:
04 January 2017 (eFirst)


Introduction This study is a systematic review on recent developments about the importance of HMGB1 protein in the pathogenesis of rhino-sinusal inflammatory diseases. We also report data on the use of 18-β-glycyrrhetic acid (GA), which has been shown able to inhibit the pro-inflammatory activities of HMGB1, in young patients affected by allergic rhinitis and complaining of nasal obstruction as main symptom.

Objectives The objective of this study was to review the literature to demonstrate the importance of HMGB1 in the pathogenesis of nasal inflammatory disorders and understand whether the inhibition of this protein may be an efficacious and innovative therapeutic strategy for patients with rhino-sinusal inflammation.

Data Synthesis Authors searched for pertinent articles indexed in PubMed, Scopus, and other health journals between 2004 and 2015.

In total, the authors gathered 258 articles: 219 articles through Pubmed and 39 articles from other search engines. The search terms used were as follows: HMGB1 AND “respiratory epithelium,” “airway inflammation,” “rhinitis,” “allergic rhinitis,” “rhinosinusitis,” “nasal polyposis,” “glycyrrhetic acid,” “children.”

Conclusions Patients with severe symptoms have the highest serum levels and the highest extracellular expression of HMGB1. GA inhibits HMGB1 chemotactic and mitogenic function by a scavenger mechanism on extracellular HMGB1 accumulation stimulated by lipopolysaccharides in vitro. Treatment of allergic rhinitis with GA is not associated with local or systemic side effects in children and adults.