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.
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.
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DOI：
10.1097/md.0000000000004651
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发表时间：
2016-08
期刊：
影响因子：
1.6
通讯作者：
Briassoulis G
中科院分区：
文献类型：
--
作者：
Fitrolaki MD;Dimitriou H;Venihaki M;Katrinaki M;Ilia S;Briassoulis G
哺乳动物热休克蛋白（HSP）90α对环境损伤有快速反应。我们检验了这样一个假设，即与健康儿童（H）相比，全身炎症反应综合征（SIRS）、严重脓毒症（SS）和/或脓毒症（S）中不仅血清HSP 72升高，而且HSP 90 α也升高;我们评估了HSP 90 α与（a）多器官系统衰竭（MOSF）和（B）炎症-代谢反应和疾病严重程度的关系。共纳入65名患有S、SS或SIRS和25名H的儿童。ELISA法检测细胞外HSP 90 α、HSP 72、化学发光白细胞介素（IL）、流式细胞术检测嗜中性粒细胞CD 64（nCD 64）表达。MOSF患者HSP 90 α、沿着HSP 72表达明显增高。脓毒症组和SIRS组HSP 90 α水平均高于H组（P <0.01）。 HSP 90 α与预计死亡率、病情严重程度独立相关，与HSP 72、nCD 64、IL、住院时间、呼吸机使用天数、发热呈正相关，与HDL、LDL呈负相关（P <0.05）。 SS/S组HSP 72表达增加，与HDL、LDL呈负相关（P <0.05）。 严重脓毒症患儿血清HSP 90 α水平明显升高，并与MOSF相关。与HSP 72相比，HSP 90 α在SS、SIRS和MOSF方面也有所增加，但与炎症应激、发热、结局终点和预测死亡率相关，与低LDL/低HDL应激代谢模式呈负相关。
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.