The Relationship of Serum Heat Shock Protein 70 Antibody Levels with the Inflammatory Factors and Serum Uric Acid Levels in Hemodialysis Patients

Heat shock proteins are extracellular inflammatory intermediaries and intracellular cytoprotective molecules. Despite many studies on intracellular HSP70, the clinical association between inflammatory biomarkers and extracellular HSP70 antibody (anti-HSP70) levels is not well-studied. The aim of this study was to investigate whether raised serum anti-HSP70 in hemodialysis (HD) patients are related to levels of serum inflammatory markers and uric acid, as the key players, in the pathogenesis of the disease. This cross-sectional study was carried out from January 2018 to July 2018, on patients referred by the nephrologists from the central outpatient dialysis center of a governmental university-affiliated hospital, in Ahvaz, Iran. Ninety HD patients enrolled based on the inclusion and exclusion criteria. Blood samples were collected directly from the arteriovenous fistula before a routine HD session. The circulating levels of anti-HSP70, highly sensitive C-reactive protein (hs-CRP), Interleukin-6 (IL-6), and endotoxin were measured by Enzyme-linked immunosorbent assay (ELISA). The univariate regression analysis revealed a significant association between serum anti-HSP70 level and diabetes mellitus, hypertension, hemodialysis vintage, uric acid, hs-CRP, and IL-6 (P < 0.05). In a multiple regression model, after adjusting for confounders, the association between circulating anti-HSP70 and uric acid (B = 16.92, P = 0.001), hs-CRP (B = 11.77, P = 0.002), IL-6 (B = 2.87, P = 0.002), endotoxin (B = 0.14, P = 0.005), and hemodialysis vintage (B = 43.76, P = 0.002) was significant. Our findings suggest that the development of the excessive systemic inflammatory response and uric acid contribute to a higher serum anti-HSP70 leading to cardiovascular disease.