Changes in anti-heat shock protein 27 antibody and C-reactive protein levels following cardiac surgery and their association with cardiac function in patients with cardiovascular disease

Abstract

The relationship between serum anti-heat shock protein (Hsp)27 antibody and high sensitive C-reactive protein (hs-CRP) levels and indices of cardiac function were investigated in patients undergoing coronary artery bypass grafting (CABG) or heart valve replacement. The changes in anti-Hsp27 antibody titers and hs-CRP levels were compared among patients undergoing off-pump and on-pump CABG or valvular heart replacement. Fifty-three patients underwent off-pump, on-pump CABG, and heart valvular replacement in each group. Serum anti-Hsp27 titers and hs-CRP values were measured 24 h before and after the operation and at discharge. Echocardiography was performed before surgery and before discharge. The results were compared with values from 83 healthy controls. hs-CRP levels increased and anti-Hsp27 antibody decreased following surgery (P < 0.001 and P < 0.05, respectively), although these changes were independent of operative procedure (P = 0.361 and P = 0.120, respectively). Anti-Hsp27 antibody levels were higher at the time of discharge (P = 0.016). Only in coronary patients were anti-Hsp27 antibody levels negatively associated with E/E' (r = -0.268, P = 0.022), a marker of pulmonary capillary wedge pressure. In conclusions, anti-Hsp27 antibody levels are associated with indices of cardiac function in coronary patients. Cardiopulmonary bypass had no significant effect on the induction of changes in anti-Hsp27 levels. Moreover, anti-Hsp27 antibody levels fell in all groups postoperatively; this may be due to the formation of immune complexes of antigen-antibody, and antibody levels were higher at the time of discharge.

Increased expression of phosphorylated forms of heat‐shock protein‐27 and p38MAPK in macrophage‐rich regions of fibro‐fatty atherosclerotic lesions in the rabbit

“…However, previous studies have shown that the concentration of circulating Hsp27 antibodies are high in patients with coronary heart disease (Ghayour-Mobarhan et al 2007;Shams et al 2008;Pourghadamyari et al 2011). These anti-Hsp27 antibodies may form immune complexes with Hsp27 antigen that are cleared from the circulation via the FC receptors of the cells of the reticuloendothelial system (Rahsepar et al 2013) which provides a potential explanation for the reduction in circulating Hsp27 levels and eventually to low concentrations in the atherosclerotic lesions. Significance of increased expressions of Hsp27, p38MAPK and their phosphorylated forms in atherosclerotic lesions and the myocardium…”

“…These anti‐Hsp27 antibodies may form immune complexes with Hsp27 antigen that are cleared from the circulation via the FC receptors of the cells of the reticuloendothelial system (Rahsepar et al . ) which provides a potential explanation for the reduction in circulating Hsp27 levels and eventually to low concentrations in the atherosclerotic lesions.…”

Hsp-27 levels and thrombus burden relate to clinical outcomes in patients with ST-segment elevation myocardial infarction

“…Several lines of evidence support the emerging role of Hsp-27 in modulating atheroprogression, by altering the inflammatory components of atherosclerotic plaques and subsequent thrombus formation [ 20 , 21 ]. Cardiopulmonary bypass had no significant effect on the induction of changes in anti-Hsp-27 levels,which may be due to the formation of immune complexes of antigen–antibody, and antibody levels were higher at the time of discharge [ 22 ]. However, serum levels of Hsp-27 are increased in patients undergoing on-pump CABG operation as compared with off-pump CABG technique, owing to spillage of known immune modulatory and apoptosis-associated proteins after CABG operation [ 23 ].…”

Evidence on the pathogenic role of auto-antibodies in acute cardiovascular diseases

“…et al [147] Azarpazhooh M.R. et al [148] Pourghadamyari H. et al [149] Sahebkar A et al [150] Rahsepar A.A. et al [151] Rahsepar A.A. et al [152] HSP: heat shock protein; Hyp: hypertension; MI: myocardial infarction; UA: unstable angina; DM: diabetes mellitus; CAD: coronary artery disease; VHD: valvular heart disease; OR: odds ratio. CD14/TLR (TLR2 and TLR4) pathway, involving the downstream activation of NF-κB and MAPKs (126)(127)(128)(129)(130).…”