Extracellular hsp70 levels in children with septic shock

Objective: To determine whether hsp70 is elevated in the plasma of children with septic shock. Design:Cohort study. Setting: Two academic, tertiary pediatric intensive care units. Patients: Ninety-four children admitted to the pediatric intensive care unit with septic shock and 24 control children undergoing elective surgical procedures. Interventions: Venous or arterial blood sampling. Measurements and main results: Children admitted to the pediatric intensive care unit with a diagnosis of septic shock were enrolled in the study following written informed consent. The control group consisted of healthy children undergoing elective surgical procedures. Blood samples from children in the septic shock or control groups were obtained within 24 hrs of admission to the pediatric intensive care unit or during the preoperative visit. Samples were collected, centrifuged, and stored at -70°C. The hsp70 levels were measured using a commercially available enzyme-linked immunosorbent assay. Results were analyzed by Wilcoxon's rank sum test. Extracellular hsp70 levels in children with septic shock were significantly elevated compared with control patients (51.6 ng/mL vs. 8.1 ng/mL, respectively, p =.0004). Conclusions: Extracellular hsp70 levels are significantly elevated in children with septic shock compared with controls. Given the newly described cell signaling properties of hsp70, these data suggest that extracellular hsp70 may play a role in the host response during septic shock.