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

Background: 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. Objectives: 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. Methods: 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 HDsession. 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). Results: 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. Conclusions: 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.