Association of increased serum heat shock protein 70 and C-reactive protein concentrations and decreased serum alpha(2)-HS glycoprotein concentration with the syndrome of hemolysis, elevated liver enzymes, and low platelet count.
The primary aim of this study was to determine serum Hsp70 concentrations in HELLP syndrome. We measured also the serum concentrations of three acute phase proteins: C-reactive protein (CRP), alpha(2)-macroglobulin (AMG) and alpha(2)-HS glycoprotein (AHSG). Ten severe preeclamptic patients with HELLP syndrome, 20 severe preeclamptic patients without HELLP syndrome and 20 normotensive, healthy pregnant women were included in this case-control study. Serum concentrations of Hsp70, CRP, AMG and AHSG were measured using an enzyme-linked immunosorbent assay (Hsp70), particle-enhanced immunoturbidimetric assay (CRP) and radial immunodiffusion (AMG, AHSG). The serum Hsp70 and CRP concentrations were significantly higher, whereas the serum AHSG concentration was significantly lower in the HELLP group (H) than the severe preeclamptic (P) and control (C) groups (median (25-75 percentile); Hsp70: 2.02 ng/ml (0.76-2.23) (H) versus 0.54 ng/ml (0.47-0.79) (P), p<0.01, and 0.30 ng/ml (0.27-0.33) (C), p<0.001; CRP: 43.9 mg/l (27.1-84.5) (H) versus 6.5 mg/l (2.7-10.7) (P), p<0.001, and 2.5 mg/l (1.1-6.7) (C), p<0.001; AHSG: 588 microg/ml (492-660) (H) versus 654 microg/ml (576-768) (P), p<0.05, and 738 microg/ml (666-804) (C), p<0.01, respectively). The serum AMG concentration did not differ between the study groups. In the HELLP group, there was a statistically significant negative correlation between serum Hsp70 concentration and platelet count (Spearman R=-0.69, p=0.026). In conclusion, serum Hsp70 and CRP concentrations are increased, whereas serum AHSG concentration is decreased, in HELLP syndrome. The maternal systemic inflammation seems to be more pronounced in HELLP syndrome than preeclampsia without HELLP syndrome, as suggested by the alterations in serum CRP and AHSG levels. However, it requires further investigation to determine whether these changes are causes or consequences of the disease.
Molvarec
Attila
A
Department of Obstetrics and Gynecology, Kútvölgyi Clinical Center, Semmelweis University, Budapest, Hungary. Electronic address: molvarec@freemail.hu.
Prohászka
Zoltán
Z
3rd Department of Internal Medicine, Semmelweis University and Research Group on Metabolism and Atherosclerosis, Hungarian Academy of Sciences, Budapest, Hungary.
Nagy
Bálint
B
1st Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary.
Kalabay
László
L
Department of Family Medicine, Semmelweis University, Budapest, Hungary.
Szalay
János
J
Department of Obstetrics and Gynecology, Kútvölgyi Clinical Center, Semmelweis University, Budapest, Hungary.
Füst
Georg
G
3rd Department of Internal Medicine, Semmelweis University and Research Group on Metabolism and Atherosclerosis, Hungarian Academy of Sciences, Budapest, Hungary.
Karádi
István
I
3rd Department of Internal Medicine, Semmelweis University and Research Group on Metabolism and Atherosclerosis, Hungarian Academy of Sciences, Budapest, Hungary.
Rigó
János
J
1st Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary.
D000328:Adult; D001798:Blood Proteins / Q000032:analysis*; D002097:C-Reactive Protein / Q000032:analysis*; D016022:Case-Control Studies; D005260:Female; D018840:HSP70 Heat-Shock Proteins / Q000097:blood*; D006461:Hemolysis; D006801:Humans; D008099:Liver / Q000201:enzymology; D010976:Platelet Count; D011225:Pre-Eclampsia / Q000097:blood*; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000097:blood*; D013577:Syndrome; D060749:alpha-2-HS-Glycoprotein
C556354:AHSG protein, human; D001798:Blood Proteins; D018840:HSP70 Heat-Shock Proteins; D060749:alpha-2-HS-Glycoprotein; D002097:C-Reactive Protein