Association between heat shock protein 70 gene polymorphisms and clinical outcomes in intensive care unit patients with sepsis.

[scrub typhus]

The objective of the following study is to evaluate the associations between single nucleotide polymorphisms (SNPs ) in the Heat Shock Protein 70 (HSP 70 ) gene , gene expression of interleukin-6 (IL -6 ) and tumor necrosis factor -alpha (TNF -α ) and medical intensive care unit (MICU ) stay and organ failure in sepsis .MICU patients with sepsis were genotyped for rs 1061581 , rs 2227956 , rs 1008438 and rs 1043618 polymorphisms in HSP 70 gene using polymerase chain reaction (PCR )-restriction fragment length polymorphism analysis or allele-specific PCR . Messenger ribonucleic acid (mRNA ) expression of IL -6 and TNF -α were quantitated in peripheral blood lymphocytes . Outcomes were recorded .108 patients (48 male ) aged 40 .7 ± 16 .0 (mean ± standard deviation ) years included H 1 N 1 infection (36 ), scrub typhus (29 ) and urosepsis (12 ). Seventy -one (65 .7 %) had dysfunction of three or more organ systems , 66 patients (61 .1 %) were treated by mechanical ventilation , 21 (19 .4 %) needed dialysis . ICU stay was 9 .3 ± 7 .3 days . Mortality was 38 .9 %. One or more SNPs were noted in 101 /108 (93 .5 %) and organ failure was noted in only 1 /7 patients without a single SNP . The A allelotypes of rs 1061581 and rs 1008438 were associated with hematological dysfunction (P = 0 .03 and 0 .07 ) and longer ICU stay (P = 0 .05 and 0 .04 ), whereas IL -6 and TNF -α mRNA levels were associated with central nervous system dysfunction .HSP 70 genotypes may determine some adverse outcomes in patients with sepsis .