Elevated serum 70 kDa heat shock protein level reflects tissue damage and disease severity in the syndrome of hemolysis, elevated liver enzymes, and low platelet count.
OBJECTIVE
We have recently demonstrated that serum 70 kDa heat shock protein (Hsp70) levels are increased in the syndrome of hemolysis, elevated liver enzymes, and low platelet count (HELLP syndrome). The aim of the present study was to investigate in an independent, larger cohort of patients whether serum Hsp70 levels are related to laboratory markers of HELLP syndrome.


METHODS
The study population included 14 patients with HELLP syndrome. Serum Hsp70 levels were measured by enzyme-linked immunosorbent assay. The relationship between serum Hsp70 levels and laboratory markers of hemolysis, hepatocellular damage, renal insufficiency, inflammation or disseminated intravascular coagulation (DIC), as well as platelet count was investigated by calculating correlation coefficients, standardized regression coefficients and by principal component analysis.


RESULTS
Serum Hsp70 levels showed a very strong correlation to the markers of hemolysis (plasma free hemoglobin level, serum lactate dehydrogenase activity, and total bilirubin level) and of hepatocellular injury (serum aminotransferase activities), supported also by principal component analysis. Furthermore, circulating Hsp70 concentration reflected the severity of HELLP syndrome as expressed by the significant inverse correlation to the lowest platelet count. By contrast, there was no relationship between serum Hsp70 levels and markers of inflammation, coagulation, fibrinolysis or renal insufficiency.


CONCLUSIONS
Elevated serum 70 kDa heat shock protein level seems to reflect tissue damage (hemolysis and hepatocellular injury) and disease severity in patients with HELLP syndrome. However, further investigations are needed to determine the clinical relevance of these findings.
Madách
Krisztina
K
Department of Anesthesiology and Intensive Therapy, Semmelweis University, Budapest, Hungary.
Molvarec
Attila
A
Rigó
János
J
Nagy
Bálint
B
Pénzes
István
I
Karádi
István
I
Prohászka
Zoltán
Z
D000328:Adult; D001663:Bilirubin / Q000097:blood; D015415:Biomarkers / Q000097:blood; D004211:Disseminated Intravascular Coagulation / Q000097:blood* / Q000503:physiopathology; D005260:Female; D005342:Fibrinolysis / Q000502:physiology; D017359:HELLP Syndrome / Q000097:blood* / Q000503:physiopathology; D018840:HSP70 Heat-Shock Proteins / Q000097:blood*; D006461:Hemolysis; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008099:Liver / Q000201:enzymology / Q000503:physiopathology*; D010976:Platelet Count; D011247:Pregnancy; D051437:Renal Insufficiency / Q000097:blood* / Q000503:physiopathology; D012720:Severity of Illness Index; D000637:Transaminases / Q000378:metabolism
D015415:Biomarkers; D018840:HSP70 Heat-Shock Proteins; D007770:L-Lactate Dehydrogenase; D000637:Transaminases; D001663:Bilirubin