CARDIOVASCULAR MEDICINE

Myocardial ischaemia and the inflammatory response: release of heat shock protein 70 after myocardial infarction

B Dybdahl^1,*, S A Slørdahl³, A Waage⁴, P Kierulf², T Espevik¹, A Sundan¹

¹ Institute of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
² The R & D Group, Department of Clinical Chemistry, Ulleval University Hospital, Oslo, Norway
³ Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology
⁴ Department of Medicine, Section for Haematology, Trondheim University Hospital, Trondheim, Norway

Correspondence to:
Correspondence to:
Dr Brit Dybdahl
Department of Oncology, Ulleval University Hospital, 0407 Oslo, Norway; brit.dybdahl{at}ulleval.no

Objectives: To test the hypothesis that heat shock protein (Hsp) 70 may be released into the circulation after acute myocardial infarction (AMI) by exploring the kinetics of Hsp70 release and the relations between Hsp70 and markers of inflammation and myocardial damage in AMI.

Design: Blood samples from 24 patients were prospectively collected through to the first day after AMI. Hsp70, interleukin (IL) 6, IL-8, and IL-10 in serum were measured by enzyme linked immunosorbent assay (ELISA).

Results: Median Hsp70 concentrations in AMI patients measured at arrival, six hours thereafter, and the following morning were 686, 868, and 607 pg/ml, respectively. These concentrations were all significantly different from those of the control patients with angina with a median serum Hsp70 concentration of 306 pg/ml. Peak Hsp70 correlated with creatine kinase (CK) MB (r = 0.62, p < 0.01) and cardiac troponin T (r = 0.58, p < 0.01). Furthermore, serum Hsp70 correlated with IL-6 and IL-8 at six hours (r = 0.60, p < 0.01 and r = 0.59, p < 0.01, respectively).

Conclusions: In this study, Hsp70 was rapidly released into the circulation after AMI. Circulating Hsp70 is suggested as a marker of myocardial damage. In addition, Hsp70 may have a role in the inflammatory response after AMI.

Abbreviations: AMI, acute myocardial infarction; CK, creatine kinase; CRP, C reactive protein; cTnT, cardiac troponin T; ELISA, enzyme linked immunosorbent assay; Hsp, heat shock protein; IL, interleukin; PCI, percutaneous coronary intervention; TLR, toll-like receptor

Keywords: coronary artery disease; immunology; inflammation; ischaemia-reperfusion; myocardial infarction; signalling proteins

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