title: Early response roles for prolactin cortisol and circulating and cellular levels of heat shock proteins 72 and 90α in severe sepsis and SIRS.
abstract: OBJECTIVE
  To evaluate the early heat shock protein (HSP) and hormonal stress response of intensive care unit (ICU) patients with severe sepsis/septic shock (SS) or systemic inflammatory response syndrome (SIRS) compared to healthy subjects (H).
  
  
  METHODS
  Patients with early (first 48 hrs) SS (n = 29) or SIRS (n = 29) admitted to a university ICU and 16 H were enrolled in the study. Serum prolactin, cortisol, and plasma ACTH were determined using immunoassay analyzers. ELISA was used to evaluate extracellular HSPs (eHSP90α, eHSP72) and interleukins. Mean fluorescence intensity (MFI) values for intracellular HSPs (iHSP72, iHSP90α) were measured using 4-colour flow-cytometry.
  
  
  RESULTS
  Prolactin, cortisol, and eHSP90α levels were significantly increased in SS patients compared to SIRS and H (P < 0.003). ACTH and eHSP72 were significantly higher in SS and SIRS compared to H (P < 0.005). SS monocytes expressed lower iHSP72 MFI levels compared to H (P = 0.03). Prolactin was related with SAPS III and APACHE II scores and cortisol with eHSP90α, IL-6, and lactate (P < 0.05). In SS and SIRS eHSP90α was related with eHSP72, IL-6, and IL-10.
  
  
  CONCLUSIONS
  Prolactin, apart from cortisol, may have a role in the acute stress response in severe sepsis. In this early-onset inflammatory process, cortisol relates to eHSP90α, monocytes suppress iHSP72, and plasma eHSP72 increases.
authors.affiliation: First Critical Care Department, Evangelismos Hospital, National and Kapodistrian University of Athens, Ipsilantou 45, 10676 Athens, Greece.
authors.forename: K
authors.initials: K
authors.lastname: Vardas
authors.affiliation: First Critical Care Department, Evangelismos Hospital, National and Kapodistrian University of Athens, Ipsilantou 45, 10676 Athens, Greece.
authors.forename: K
authors.initials: K
authors.lastname: Apostolou
authors.affiliation: 1st Department of Propaedeutic Internal Medicine, Laiko University General Hospital, University of Athens, 17 Agiou Thoma, 115 27 Athens, Greece.
authors.forename: E
authors.initials: E
authors.lastname: Briassouli
authors.affiliation: 1st Department of Propaedeutic Internal Medicine, Laiko University General Hospital, University of Athens, 17 Agiou Thoma, 115 27 Athens, Greece.
authors.forename: D
authors.initials: D
authors.lastname: Goukos
authors.affiliation: Immunology-Histocompatibility Department, Evangelismos Hospital, Ipsilantou 45, 10676 Athens, Greece.
authors.forename: K
authors.initials: K
authors.lastname: Psarra
authors.affiliation: Department of Endocrinology and Diabetes, Evangelismos Hospital, Ipsilantou 45, 10676 Athens, Greece.
authors.forename: E
authors.initials: E
authors.lastname: Botoula
authors.affiliation: Department of Endocrinology and Diabetes, Evangelismos Hospital, Ipsilantou 45, 10676 Athens, Greece.
authors.forename: S
authors.initials: S
authors.lastname: Tsagarakis
authors.affiliation: First Critical Care Department, Evangelismos Hospital, National and Kapodistrian University of Athens, Ipsilantou 45, 10676 Athens, Greece.
authors.forename: E
authors.initials: E
authors.lastname: Magira
authors.affiliation: First Critical Care Department, Evangelismos Hospital, National and Kapodistrian University of Athens, Ipsilantou 45, 10676 Athens, Greece.
authors.forename: C
authors.initials: C
authors.lastname: Routsi
authors.affiliation: First Critical Care Department, Evangelismos Hospital, National and Kapodistrian University of Athens, Ipsilantou 45, 10676 Athens, Greece.
authors.forename: S
authors.initials: S
authors.lastname: Nanas
authors.affiliation: Pediatric Intensive Care Unit, School of Health Sciences, University Hospital, University of Crete, 71110 Heraklion, Greece.
authors.forename: G
authors.initials: G
authors.lastname: Briassoulis
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D016022:Case-Control Studies; D005260:Female; D050884:HSP72 Heat-Shock Proteins / Q000097:blood*; D018841:HSP90 Heat-Shock Proteins / Q000097:blood*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011388:Prolactin / Q000097:blood*; D018805:Sepsis / Q000097:blood* / Q000453:epidemiology; D013312:Stress, Physiological; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood* / Q000453:epidemiology
chemical_list: D050884:HSP72 Heat-Shock Proteins; D018841:HSP90 Heat-Shock Proteins; C533585:HSP90AA2P protein, human; D000324:Adrenocorticotropic Hormone; D011388:Prolactin; D006854:Hydrocortisone