Evaluation of the diagnostic and prognostic values of serum HSP90 alpha in sepsis patients: a retrospective study

Background: Sepsis is a serious syndrome that is caused by immune responses dysfunction and leads to high mortality. The abilities of heat shock protein 90 alpha (HSP90 alpha) 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 HSP90 alpha 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 HSP90 alpha 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 HSP90 alpha with sepsis survival. Moreover, serum IL-1 beta, IL-18, MIP-3 alpha, and ENA-78 were also determined. Finally, Spearman correlation analysis was employed to reveal a possible mechanism that HSP90 alpha contributed to the short-term deaths. Results: Serum HSP90 alpha 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 HSP90 alpha was an independent risk factors for sepsis mortality. Receiver operating characteristic (ROC) analysis displayed that HSP90 alpha 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 HSP90 alpha levels, especially the levels of HSP90 alpha were greater than 120 ng/mL (P < 0.001). Moreover, among sepsis patients, those who died had notably elevated cytokines, IL-1 beta, IL-18, and chemokines, MIP-3 alpha, ENA-78, relative to survivors. Further correlation analysis demonstrated that there was a nominally positive correlation between HSP90 alpha and IL-1 beta, IL-18, and MIP-3 alpha. Conclusion: HSP90 alpha is of favorable clinical significance in sepsis diagnosis and prognosis, laying a foundation for future clinical applications.