Elevated serum 70kDa heat shock protein level reflects tissue damage and disease severity in the syndrome of hemolysis, elevated liver enzymes, and low platelet count

Madách, Krisztina; Molvarec, Attila; Rigó, János; Nagy, Bálint; Pénzes, István; Karádi, István; Prohászka, Zoltán

doi:10.1016/j.ejogrb.2007.12.012

« Previous Next »European Journal of Obstetrics & Gynecology and Reproductive Biology
Volume 139, Issue 2 , Pages 133-138, August 2008

Elevated serum 70kDa heat shock protein level reflects tissue damage and disease severity in the syndrome of hemolysis, elevated liver enzymes, and low platelet count

Krisztina Madách
- Department of Anesthesiology and Intensive Therapy, Semmelweis University, Budapest, Hungary
- These authors contributed equally to this paper.
Attila Molvarec
- 1st Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
- These authors contributed equally to this paper.
- Corresponding author at: Hangya lépcső 7, Budapest, H-1121, Hungary. Tel.: +36 20 957 1636; fax: +36 1 355 8251.
János Rigó Jr.
- 1st Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
Bálint Nagy
- 1st Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
István Pénzes
- Department of Anesthesiology and Intensive Therapy, Semmelweis University, Budapest, Hungary
István Karádi
- 3rd Department of Internal Medicine, and Szentágothai Knowledge Center, Semmelweis University, Budapest, Hungary
Zoltán Prohászka
- 3rd Department of Internal Medicine, and Szentágothai Knowledge Center, Semmelweis University, Budapest, Hungary
- Research Group of Inflammation Biology and Immunogenomics, Hungarian Academy of Sciences, Budapest, Hungary

Received 22 August 2007; received in revised form 8 November 2007; accepted 23 December 2007. published online 13 February 2008.

Abstract

Objective

We have recently demonstrated that serum 70kDa heat shock protein (Hsp70) levels are increased in the syndrome of hemolysis, elevated liver enzymes, and low platelet count (HELLP syndrome). The aim of the present study was to investigate in an independent, larger cohort of patients whether serum Hsp70 levels are related to laboratory markers of HELLP syndrome.

Study design

The study population included 14 patients with HELLP syndrome. Serum Hsp70 levels were measured by enzyme-linked immunosorbent assay. The relationship between serum Hsp70 levels and laboratory markers of hemolysis, hepatocellular damage, renal insufficiency, inflammation or disseminated intravascular coagulation (DIC), as well as platelet count was investigated by calculating correlation coefficients, standardized regression coefficients and by principal component analysis.

Results

Serum Hsp70 levels showed a very strong correlation to the markers of hemolysis (plasma free hemoglobin level, serum lactate dehydrogenase activity, and total bilirubin level) and of hepatocellular injury (serum aminotransferase activities), supported also by principal component analysis. Furthermore, circulating Hsp70 concentration reflected the severity of HELLP syndrome as expressed by the significant inverse correlation to the lowest platelet count. By contrast, there was no relationship between serum Hsp70 levels and markers of inflammation, coagulation, fibrinolysis or renal insufficiency.

Conclusion

Elevated serum 70kDa heat shock protein level seems to reflect tissue damage (hemolysis and hepatocellular injury) and disease severity in patients with HELLP syndrome. However, further investigations are needed to determine the clinical relevance of these findings.

Keywords: Heat shock protein 70, HELLP syndrome, Pre-eclampsia, Marker, Hemolysis, Hepatocellular injury