Pediatric Critical Care Medicine:
Abstracts of the 7th World Congress on Pediatric Critical Care
1PICU University Hospital, University of Crete, Heraklion, Greece 2Paediatric Haematology Oncology, University of Crete, Heraklion, Greece 3Clinical Biochemistry, University of Crete, Heraklion, Greece
Background and aims: Heat-shock-proteins (HSPs) act as inducers of interleukins (ILs) and stimulants for immune cells during SIRS. Little is known on the role of extracellular HSP72/HSP90 in sepsis (S) or severe sepsis/septic shock (SS).
Aims: We determined serum HSP90/HSP72 and ILs in children with S or SS compared to SIRS (trauma) or healthy children (H).
Methods: Critically ill children with S (n=15), SS (n=15) or SIRS (n=19) and H (n=16) were enrolled in the study. ELISA was used to evaluate HSPs and ILs, flow-cytometry to evaluate CD64 expression (IRB approved).
Results: Only patients with SS compared to H had elevated HSP90 (670 ± 1300 vs. 59 ± 11pg/mL, p<0.0001), IL8 (1253 ± 2780 vs. 11 ± 9.7ng/mL, p<0.02), IL10 (148 ± 373 vs. 8 ± 9.8ng/mL, p<0.02), TNFα (41 ± 34 vs. 13 ± 3ng/mL, p<0.03), and a trend for HSP72 (95.5 ± 360 vs. 0.6 ± 1.8pg/mL, p<0.06). HSP90 related to CD64, IL8, IL10, CRP, PRISM, PELOD, TISS, LOS (p<0.001). Negatively to HDL related HSP72, HSP90, IL8 (p<0.001); negatively to LDL related HSP90, IL8, IL10 (p<0.02). In a logistic regression model, only HSP90 (among biomarkers or severity of illness scores) was independently associated with mortality (p<0.0001).
Conclusions: Extracellular HSP90 levels are significantly elevated in children with septic shock and relate to CD64, IL8, IL10, severity of illness, and outcome. The negative correlations of HSPs and ILs with LDL or HDL need further elucidation.
GRANT ACKNOWLEDGMENT. This research has been co-financed by the European Union (European Social Fund (ESF)) and Greek national funds through the Operational Program ‘‘Education and Lifelong Learning’’ of the National Strategic Reference Framework (NSRF)-Research Funding Program: THALES.