title: Increased extracellular heat shock protein 90α in severe sepsis and SIRS associated with multiple organ failure and related to acute inflammatory-metabolic stress response in children.
abstract: Mammalian heat-shock-protein (HSP) 90α rapidly responses to environmental insults. We examined the hypothesis that not only serum HSP72 but also HSP90α is increased in the systemic inflammatory response syndrome (SIRS), severe-sepsis (SS), and/or sepsis (S) compared to healthy children (H); we assessed HSP90α relation to (a) multiple organ system failure (MOSF) and (b) inflammatory-metabolic response and severity of illness.A total of 65 children with S, SS, or SIRS and 25 H were included. ELISA was used to evaluate extracellular HSP90α and HSP72, chemiluminescence interleukins (ILs), flow-cytometry neutrophil-CD64 (nCD64)-expression.HSP90α, along with HSP72, were dramatically increased among MOSF patients. Patients in septic groups and SIRS had elevated HSP90α compared to H (P < 0.01). HSP90α was independently related to predicted death rate and severity of illness; positively to HSP72, nCD64, ILs, length of stay, days on ventilator, and fever; negatively to HDL and LDL (P < 0.05). The HSP72 was increased in SS/S and related negatively to HDL and LDL (P < 0.05).Serum HSP90α is markedly elevated in children with severe sepsis and is associated with MOSF. Better than the HSP72, also increased in SS, SIRS, and MOSF, HSP90α is related to the inflammatory stress, fever, outcome endpoints, and predicted mortality and inversely related to the low-LDL/low-HDL stress metabolic pattern.
authors: Pediatric Intensive Care Unit, University of Crete, University Hospital Pediatric Haematology Oncology Department of Clinical Chemistry, University of Crete, Medical School, Heraklion, Greece.
authors: Michaela-Diana
authors: MD
authors: Fitrolaki
authors: Helen
authors: H
authors: Dimitriou
authors: Maria
authors: M
authors: Venihaki
authors: Marianna
authors: M
authors: Katrinaki
authors: Stavroula
authors: S
authors: Ilia
authors: George
authors: G
authors: Briassoulis
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D050884:HSP72 Heat-Shock Proteins / Q000097:blood*; D018841:HSP90 Heat-Shock Proteins / Q000097:blood*; D006801:Humans; D007378:Interleukins / Q000097:blood; D007902:Length of Stay; D008297:Male; D009102:Multiple Organ Failure; D009504:Neutrophils / Q000276:immunology; D011446:Prospective Studies; D017452:Receptors, IgG / Q000097:blood; D018805:Sepsis; D018746:Systemic Inflammatory Response Syndrome
chemical_list: D050884:HSP72 Heat-Shock Proteins; D018841:HSP90 Heat-Shock Proteins; D007378:Interleukins; D017452:Receptors, IgG