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BioMed Research International
Volume 2014, Article ID 803561, 8 pages
http://dx.doi.org/10.1155/2014/803561
Research Article

Early Response Roles for Prolactin Cortisol and Circulating and Cellular Levels of Heat Shock Proteins 72 and 90α in Severe Sepsis and SIRS

1First Critical Care Department, Evangelismos Hospital, National and Kapodistrian University of Athens, Ipsilantou 45, 10676 Athens, Greece
21st Department of Propaedeutic Internal Medicine, Laiko University General Hospital, University of Athens, 17 Agiou Thoma, 115 27 Athens, Greece
3Immunology-Histocompatibility Department, Evangelismos Hospital, Ipsilantou 45, 10676 Athens, Greece
4Department of Endocrinology and Diabetes, Evangelismos Hospital, Ipsilantou 45, 10676 Athens, Greece
5Pediatric Intensive Care Unit, School of Health Sciences, University Hospital, University of Crete, 71110 Heraklion, Greece

Received 7 March 2014; Accepted 24 July 2014; Published 27 August 2014

Academic Editor: Baoli Cheng

Copyright © 2014 K. Vardas et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. 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). Methods. Patients with early (first 48 hrs) SS () or SIRS () 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. Results. Prolactin, cortisol, and eHSP90α levels were significantly increased in SS patients compared to SIRS and H (). ACTH and eHSP72 were significantly higher in SS and SIRS compared to H (). SS monocytes expressed lower iHSP72 MFI levels compared to H (). Prolactin was related with SAPS III and APACHE II scores and cortisol with eHSP90α, IL-6, and lactate (). In SS and SIRS eHSP90α was related with eHSP72, IL-6, and IL-10. Conclusion. 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.