Vardas K, Apostolou K, Briassouli E, Goukos D, Psarra K, Botoula E, Tsagarakis S, Magira E, Routsi C, Nanas S, Briassoulis G
First Critical Care Department, Evangelismos Hospital, National and Kapodistrian University of Athens, Ipsilantou 45, 10676 Athens, Greece.
1st Department of Propaedeutic Internal Medicine, Laiko University General Hospital, University of Athens, 17 Agiou Thoma, 115 27 Athens, Greece.
Biomed Res Int. 2014;2014:803561. doi: 10.1155/2014/803561. Epub 2014 Aug 27.
To evaluate the early heat shock protein (HSP) and hormonal stress response of intensive care unit (ICU) patients with severe sepsis/septic shock (SS) or systemic inflammatory response syndrome (SIRS) compared to healthy subjects (H).
Patients with early (first 48 hrs) SS (n = 29) or SIRS (n = 29) admitted to a university ICU and 16 H were enrolled in the study. Serum prolactin, cortisol, and plasma ACTH were determined using immunoassay analyzers. ELISA was used to evaluate extracellular HSPs (eHSP90α, eHSP72) and interleukins. Mean fluorescence intensity (MFI) values for intracellular HSPs (iHSP72, iHSP90α) were measured using 4-colour flow-cytometry.
Prolactin, cortisol, and eHSP90α levels were significantly increased in SS patients compared to SIRS and H (P < 0.003). ACTH and eHSP72 were significantly higher in SS and SIRS compared to H (P < 0.005). SS monocytes expressed lower iHSP72 MFI levels compared to H (P = 0.03). Prolactin was related with SAPS III and APACHE II scores and cortisol with eHSP90α, IL-6, and lactate (P < 0.05). In SS and SIRS eHSP90α was related with eHSP72, IL-6, and IL-10.
Prolactin, apart from cortisol, may have a role in the acute stress response in severe sepsis. In this early-onset inflammatory process, cortisol relates to eHSP90α, monocytes suppress iHSP72, and plasma eHSP72 increases.
评估重症监护病房（ICU）中患有严重脓毒症/脓毒性休克（SS）或全身炎症反应综合征（SIRS）的患者与健康受试者（H）相比的早期热休克蛋白（HSP）和激素应激反应。
纳入一所大学ICU收治的早期（最初48小时）SS患者（n = 29）或SIRS患者（n = 29）以及16名健康受试者进行研究。使用免疫分析仪器测定血清催乳素、皮质醇和血浆促肾上腺皮质激素（ACTH）。采用酶联免疫吸附测定（ELISA）评估细胞外HSP（eHSP90α、eHSP72）和白细胞介素。使用四色流式细胞术测量细胞内HSP（iHSP72、iHSP90α）的平均荧光强度（MFI）值。
与SIRS患者和健康受试者相比，SS患者的催乳素、皮质醇和eHSP90α水平显著升高（P < 0.003）。与健康受试者相比，SS和SIRS患者的ACTH和eHSP72显著更高（P < 0.005）。与健康受试者相比，SS患者的单核细胞表达的iHSP72 MFI水平较低（P = 0.03）。催乳素与序贯器官衰竭评估（SOFA）评分和急性生理与慢性健康状况评分系统II（APACHE II）评分相关，皮质醇与eHSP90α、白细胞介素-6（IL-6）和乳酸相关（P < 0.05）。在SS和SIRS患者中，eHSP90α与eHSP72、IL-6和IL-10相关。
除皮质醇外催乳素可能在严重脓毒症的急性应激反应中起作用。在这个早期炎症过程中，皮质醇与eHSP90α相关，单核细胞抑制iHSP72，血浆eHSP72增加。
