Evaluation of the diagnostic and prognostic values of serum HSP90α in sepsis patients: a retrospective study

Fuxing Li; Yulin Zhang; Bocheng Yu; Zihua Zhang; Yujuan Fan; Li Wang; Mingjing Cheng; Ping Yan; Weidong Zhao

doi:10.7717/peerj.12997

Evaluation of the diagnostic and prognostic values of serum HSP90α in sepsis patients: a retrospective study

PeerJ. 2022 Mar 10:10:e12997. doi: 10.7717/peerj.12997. eCollection 2022.

Authors

Fuxing Li^#¹, Yulin Zhang^#¹, Bocheng Yu¹, Zihua Zhang¹, Yujuan Fan¹, Li Wang¹, Mingjing Cheng¹, Ping Yan², Weidong Zhao^{1

3}

Affiliations

¹ Department of Clinical Laboratory, School of Clinical Medicine, Dali University, Dali, Yunnan, China.
² Department of Gastroenterology, The First Affiliated Hospital of Dali University, Dali, Yunnan, China.
³ Institute of Translational Medicine for Metabolic Diseases, Dali University, Dali, Yunnan, China.

^# Contributed equally.

Abstract

Background: Sepsis is a serious syndrome that is caused by immune responses dysfunction and leads to high mortality. The abilities of heat shock protein 90α (HSP90α) in assessing the diagnosis and prognosis in patients with sepsis remain ill-defined to date. We conducted a study to reveal the possible clinical applications of HSP90α as biomarker for the diagnosis and prognosis in patients with sepsis.

Methods: In total, 150 patients of sepsis, 110 patients without sepsis admitted to ICU and 110 healthy subjects were involved in this study. The serum HSP90α contents, sequential organ failure assessment (SOFA) scores, procalcitonin (PCT), and short-term survival status of the participants were measured and compared. Logistic and linear regression models adjusting for potential confounders were used to examine the association of HSP90α with sepsis survival. Moreover, serum IL-1β, IL-18, MIP-3α, and ENA-78 were also determined. Finally, Spearman correlation analysis was employed to reveal a possible mechanism that HSP90α contributed to the short-term deaths.

Results: Serum HSP90α levels in sepsis patients were higher than those in ICU controls and healthy controls (P < 0.001), and even increased in patients who died within 28 days (P < 0.001). Logistic and linear regression models identified HSP90α was an independent risk factors for sepsis mortality. Receiver operating characteristic (ROC) analysis displayed that HSP90α had a considerable predictive performance for sepsis outcome, with an area under curve (AUC) value up to 0.79. Survival analysis demonstrated that the mortality of sepsis individuals at 28 days was positively associated with HSP90α levels, especially the levels of HSP90α were greater than 120 ng/mL (P < 0.001). Moreover, among sepsis patients, those who died had notably elevated cytokines, IL-1β, IL-18, and chemokines, MIP-3α, ENA-78, relative to survivors. Further correlation analysis demonstrated that there was a nominally positive correlation between HSP90α and IL-1β, IL-18, and MIP-3α.

Conclusion: HSP90α is of favorable clinical significance in sepsis diagnosis and prognosis, laying a foundation for future clinical applications.

Keywords: Biomarkers; Diagnostic and prognosis; HSP90α; SOFA; Sepsis.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Humans
Intensive Care Units
Interleukin-18*
Prognosis
Retrospective Studies
Sepsis* / diagnosis

Substances

Interleukin-18

Grants and funding

This work was supported by the National Natural Science Foundation of China (Nos. 82160361 and 81960363), the Yunnan Fundamental Research Projects (202001BA070001-040 and 202001BA070001-055) and the Yunnan Health Training Project of High Level Talents (H-2019045). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.