ORIGINAL PAPER
Is HSP-27 an emerging marker of good prognosis in septic shock
patients? A pilot study
1
Collegium Medicum, Jan Kochanowski University, Kielce, Poland
2
Department of Anesthesiology and Intensive Care, Warsaw South Hospital, Warsaw, Poland
3
Department of Anesthesiology and Intensive Care, Medical University of Lublin, Lublin, Poland
Submission date: 2023-08-03
Final revision date: 2023-08-26
Acceptance date: 2024-02-09
Publication date: 2024-03-28
Corresponding author
Andrzej Jaroszyński
Collegium Medicum, Jan Kochanowski University, Al. IX Wieków Kielc 19A, 25-317 Kielce, Poland
Collegium Medicum, Jan Kochanowski University, Al. IX Wieków Kielc 19A, 25-317 Kielce, Poland
Medical Studies 2024;40(1):17-21
KEYWORDS
TOPICS
ABSTRACT
Introduction::
Many biomarkers are used to assess the severity of sepsis and septic shock (SS), but none are highly sensitive in predicting outcome. Aim of the research: To estimate the value of serum changes of C-reactive protein, procalcitonin, presepsin, heat shock protein 27 (HSP27) and neutrophil to lymphocyte ratio in assessing the prognosis in patients with SS treated in an intensive care unit.
Material and methods::
Thirty-seven selected adult patients with SS were included. Serum concentrations of biomarkers were measured at admission and daily for 4 consecutive days (time points T0,T1, T2, T3 and T4 respectively). The mortality rate was determined 28 days after admission. Patients were divided into survivor and non-survivor groups according to their mortality. The differences between the levels of biomarkers at the time points T0 and T4 were analyzed.
Results::
The mean value of the SOFA score on admission was 11.7 ±2.7, and the APACHE II scale 29.9 ±6.85. Nine patients died. Univariate logistic analysis revealed that changes between T0 and T4 of presepsin, procalcitonin, and HSP27 were associated with prognosis. A multivariate Cox analysis showed that an increase in HSP27 at T4 was the only independent predictor of good prognosis in SS patients. The area under the receiver operating characteristics curve for HSP27 was 0.785. Kaplan-Meier analysis showed that the mortality was lower (p = 0.014) in patients who had an increase in HSP27 at T4 compared to those whose serum HSP27 did not increase at T4.
Conclusions::
The increase of HSP27 level on the 4th day predicts a favorable outcome in SS patients.
Many biomarkers are used to assess the severity of sepsis and septic shock (SS), but none are highly sensitive in predicting outcome. Aim of the research: To estimate the value of serum changes of C-reactive protein, procalcitonin, presepsin, heat shock protein 27 (HSP27) and neutrophil to lymphocyte ratio in assessing the prognosis in patients with SS treated in an intensive care unit.
Material and methods::
Thirty-seven selected adult patients with SS were included. Serum concentrations of biomarkers were measured at admission and daily for 4 consecutive days (time points T0,T1, T2, T3 and T4 respectively). The mortality rate was determined 28 days after admission. Patients were divided into survivor and non-survivor groups according to their mortality. The differences between the levels of biomarkers at the time points T0 and T4 were analyzed.
Results::
The mean value of the SOFA score on admission was 11.7 ±2.7, and the APACHE II scale 29.9 ±6.85. Nine patients died. Univariate logistic analysis revealed that changes between T0 and T4 of presepsin, procalcitonin, and HSP27 were associated with prognosis. A multivariate Cox analysis showed that an increase in HSP27 at T4 was the only independent predictor of good prognosis in SS patients. The area under the receiver operating characteristics curve for HSP27 was 0.785. Kaplan-Meier analysis showed that the mortality was lower (p = 0.014) in patients who had an increase in HSP27 at T4 compared to those whose serum HSP27 did not increase at T4.
Conclusions::
The increase of HSP27 level on the 4th day predicts a favorable outcome in SS patients.
REFERENCES (13)
1.
Singer M, Deutschman C, Seymour C, Shankar-Hari M, Annane D, Bauer M, Bellomo R, Bernard GR, Chiche JD, Coopersmith CM, Hotchkiss RS, Levy MM, Marshall JC, Martin GS, Opal SM, Rubenfeld GD, van der Poll T, Vincent JL, Angus DC. The Third International Consensus defnitions for sepsis and septic shock (Sepsis-3). JAMA 2016; 315: 801-810.
2.
Evans L, Rhodes A, Alhazzani W, Antonelli M, Cooper- smith C, French C, Machado FR, Mcintyre L, Oster- mann M, Prescott HC, Schorr C, Simpson S, Wiersin- ga WJ, Alshamsi F, Angus DC, Arabi Y, Azevedo L, Beale R, Beilman G, Belley-Cote E, Burry L, Cecconi M, Centofan- ti J, Yataco AC, De Waele J, Dellinger RP, Doi K, Du B, Estenssoro E, Ferrer R, Gomersall C, Hodgson C, Møller MH, Iwashyna T, Jacob S, Kleinpell R, Klompas M, Koh Y, Ku- mar A, Kwizera A, Lobo S, Masur H, McGloughlin S, Mehta S, Mehta Y, Mer M, Nunnally M, Oczkowski S, Osborn T, Papathanassoglou E, Perner A, Puskarich M, Roberts J, Schweickert W, Seckel M, Sevransky J, Sprung CL, Welte T, Zimmerman J, Levy M. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. Intensive Care Med 2021; 47: 1181-1247.
3.
Breed E, Hilliard C, Yoseph B, Mittal R, Liang Z, Chen C, Burd EM, Brewster LP, Hansen LM, Gleason Jr RL, Pandi- ta TK, Ford ML, Hunt CR, Coopersmith CM. The small heat shock protein HSPB1 protects mice from sepsis Sci Rep 2018; 8: 12493.
4.
Jaroszyński A, Zaborowski T, Głuszek S, Zapolski T, Sadowski M, Załuska W, Cedro A, Małecka-Massalska T, Dąbrowski W. Heat shock protein 27 is an emerging predictor of contrast-induced acute kidney injury on patients subjected to percutaneous coronary interventions. Cells 2021; 10: 684.
5.
Bolhassania A, Agi E. Heat shock proteins in infection. Clin Chim Acta 2019; 498: 90-100.
6.
Yu A, Li P, Tang J, Wang J, Chen Y, Liu L. Roles of Hsp70s in stress responses of microorganisms, plants, and animals. Biomed Res Int 2015; 2015: 510319.
7.
Zuo D, Subjeck J, Wang X. Unfolding the role of large heat shock proteins: new insights and therapeutic implications. Front Immunol 2016; 7: 75.
8.
Vulczak A, Catalão C, de Freitas L, Rocha M. HSP-target of therapeutic agents in sepsis treatment. Int J Mol Sci 2019; 20: 4255.
9.
Canul-Euan A, Zúńiga-González G, Palacios-Luna J, Maida-Claros R, Díaz N, Saltigeral-Tigeral P. Increased levels of plasma extracellular heat-shock proteins 60 and 70 kDa characterized early-onset neonatal sepsis. Front Pediatr 2021; 9: 740274.
10.
Hashiguchi N, Ogura H, Tanaka H, Koh T, Nakamori Y, Noborio M, Shiozaki T, Nishino M, Kuwagata Y, Shimazu T, Sugimoto H. Enhanced expression of heat shock proteins in activated polymorphonuclear leukocytes in patients with sepsis. J Trauma 2001; 51: 1104-1109.
11.
Wischmeyer E, Kahana M, Ren W, Musch M, Chang E. Glutamine induces heat shock protein and protects against endotoxin shock in the rat. J Appl Physiol 2001; 90: 2403-2410.
12.
Singleton K, Serkova N, Beckey V, Wischmeyer P. Glutamine attenuates lung injury and improves survival after sepsis: role of enhanced heat shock protein expression. Crit Care Med 2005; 33: 1206-1213.
13.
Zhao Y, Wang H, Liu X, Sun M. Kazuhiro H. Protective effects of glutamine in a rat model of endotoxemia. Mol Med Rep 2012; 6: 739-744.
Share
RELATED ARTICLE
| eISSN: | 2300-6722 |
| ISSN: | 1899-1874 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
