Heat shock protein 70-2 + 1267 AA homozygotes have an increased risk of septic shock in adults with community-acquired pneumonia

Grant W. Waterer*, Lama ElBahlawan, Michael W. Quasney, Qing Zhang, Lori A. Kessler, Richard G. Wunderink

*Corresponding author for this work

Research output: Contribution to journalArticle

77 Scopus citations

Abstract

Objective: Heat shock protein (HSP)70-2 is an important immunomodulatory protein induced in response to inflammatory stimuli. We assessed whether HSP70-2+1267 genotype influenced the risk of septic shock in a prospective cohort study of community-acquired pneumonia and whether HSP70-2+1267 genotype is a better predictor of septic shock than the genotype at lymphotoxin-α +250. Design: Prospective cohort study. Setting: A large, nonprofit, private hospital system in Memphis, TN. Patients: Adults admitted with community-acquired pneumonia between 1998 and 2001. Septic shock was defined according to consensus criteria (American College of Chest Physicians/Society of Critical Care Medicine, 1992). Interventions: Blood sampling. Measurements and Main Results: A total of 343 subjects were enrolled; 30 had septic shock. HSP70-2+1267 and lymphotoxin-α +250 genotype was determined using polymerase chain reaction and restriction enzyme digestion. HSP70-2+1267 AA genotype was the strongest predictor of septic shock (p = .0005; relative risk, 3.5). Lymphotoxin-α +250 AA genotype was also associated with an increased risk of septic shock (p = .002; relative risk, 2.7). Logistic regression analysis found only age (p = .04) and HSP70-2+1267 genotype (p = .006) were predictors of septic shock. The greatest risk of septic shock was associated with carriage of the HSP70-2+1267 A/lymphotoxin-α +250 A haplotype (p < .0001). Conclusions: HSP70-2+ 1267 genotype is a stronger predictor of septic shock in patients with community-acquired pneumonia than lymphotoxin-α +250 genotype.

Original languageEnglish (US)
Pages (from-to)1367-1372
Number of pages6
JournalCritical care medicine
Volume31
Issue number5
DOIs
StatePublished - May 1 2003

Keywords

  • Gene polymorphisms
  • Heat shock protein 70
  • Pneumonia
  • Septic shock

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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