Increased systemic heat-shock protein 27 and 70 following severe burn injury.

Abstract

Severe burn injuries trigger a complex systemic response, including dysregulated inflammation and immunosuppression. Heat shock proteins (HSPs) regulate cellular stress responses and have immunomodulatory functions when released into the extracellular compartment. Our aim was to investigate the release of systemic HSP27 and 70 in patients suffering from severe burn injury. We analyzed serum HSP27 and HSP70 concentrations in 32 burn patients admitted to our burn intensive care unit with a total body surface area (TBSA) affected of > 10 % in comparison to eight healthy control probands. HSP27 and 70 concentrations were determined serially for four weeks using enzyme-linked immunosorbent assays (ELISA). The mean TBSA was 32.5 % ± 19.6 %, and in-hospital mortality occurred in six patients (18.8 %). HSP27 and HSP70 concentrations were significantly elevated in burn patients compared to controls, with peak concentrations on the day of admission (HSP27: 590 ± 335 vs. 83 ± 42 pg/mL, p < 0.001; HSP70: 1961 ± 2214 vs. 189 ± 130 pg/mL, p < 0.001). HSP70 concentrations were significantly higher in non-survivors (1143 vs. 946 pg/mL, p < 0.05) and were significantly higher in patients with more than 29 % TBSA compared to patients with lower TBSA (p < 0.01). Receiver operating characteristic curve analysis identified HSP70 measured on the day of admission as a significant predictor of patient mortality. Severe thermal trauma results in elevated HSP27 and HSP70 concentrations. Increased HSP70 levels are associated with higher in-hospital mortality in burn patients, suggesting potential use as a prognostic biomarker.