Article
Serum HSP27 and HSP70 concentrations are increased and predict mortality in burn patients
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Published: | January 12, 2016 |
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Burn injuries are considered to be a severe threat to affected patients and request immediate medical treatment. An extensive burn trauma triggers a multilayered systemic immune response. Heat shock proteins (HSP) 27 and 70, acting as intracellular inducible molecular chaperones, mediate cytoprotective effects and are part of the cell´s response to a vast number of physiological and environmental stressors, including devastating thermal stress. Recent studies suggest a systemic role for extracellular HSPs. Therefore we sought to investigate the serum levels of HSP27 and HSP70 in severely burned patients in a time-dependent manner.
Serum concentrations of HSP27 and HSP70 were measured daily for 1 week after admission and weekly thereafter. We recruited 32 burn patients and 8 healthy volunteers with a statistically comparable age and gender distribution. All recruited burn patients had been admitted to the intensive care unit (ICU) with a TBSA >10% (mean ± standard deviation: 32%±19%) and a mean ABSI of 7±2. Mean HSP27 and HSP70 serum levels were significantly increased in the burn patients in comparison to the healthy volunteers at the time of admission to the ICU (584pg/ml vs. 83pg/ml, p<0.001; and 2024pg/ml vs. 252pg/ml, p<0.001) and on the first day after admission (301pg/ml vs. 81pg/ml, p<0.001; and 969pg/ml vs. 226pg/ml, p=0.029). A statistically significant difference in HSP27 serum levels was observed at each time point until day 28 after admission. We found significantly increased serum levels of HSP70 in burn patients with fatal outcome on days one (p=0.041) and two (p=0.025).
It can be concluded that HSP27 and HSP70 serum levels were highly increased in burn patients compared to healthy volunteers in our study. Our data also show increased HSP70 levels in the non-survivor group. We suggest that extracellular HSPs might play a role in the secondary systemic pathomechanism observed after thermal stress. Further studies are warranted to elucidate the concrete role of HSPs in the pathologic mechanisms following burn injury and whether HSP27 and HSP70 can be used in the intensive care management of patients with severe thermal injuries.