Anti-heat-shock protein 70 kDa antibodies in vascular patients

Introduction and aim of study: there is recent evidence that the immune sys tem plays an essential role in the pathogenesis of atherosclerosis, with bo th cellular and humoral mechanisms being involved. Heat-shock proteins (HSP s) have been detected in atherosclerotic lesions, and antibodies to HSPs ha ve also been found to be raised in patients with carotid stenoses. The aim of our study was to examine the level of anti-HSP70 antibodies in patients with other vascular diseases. Materials and methods: a questionnaire was designed for Ale subjects in the study, with documentation of clinical details and ankle-brachial pressure index. Patients with concomitant infection, malignancy, hepatorenal failure , or recent surgery were excluded. Enzyme-linked immunosorbent assay (ELISA ) was used to identify anti-HSP70 antibodies in the sera in different dilut ions. Graphs of optical density (OD) vs, negative log dilution were plotted , the gradient of which teas taken to be the estimated optical density for each subject (proportional to antibody level). Our groups consisted of cont rols (n = 21, mean age 59.0 +/- 19.2), lower limb claudicants ((n = 19, mea n age 60.0 +/- 12.6), patients with lower-limb critical ischaemia (n = 22, mean age 68.5 +/- 10.07), and patients with abdominal aortic aneurysms (n = 20, mean age 69.9 +/- 6.2). Results: we found no correlation between age and the estimated OD in our su bjects (Spearman's correlation coefficient (r) = 0.123, one-railed p value was 0.135). Patients with intermittent claudication, critical lower limb is chaemia, and aneurysms had higher Estimated OD, and therefore higher anti-H SP70 antibody levels, than controls (Mann-Whitney test; p = 0.0127, 0.0037, 0.0008, respectively). Conclusions: our data provide the first evidence of a correlation between a nti-HSP70 antibodies and different types of vascular diseases, suggesting t hat HSP70 might be involved in the pathogenesis and propagation of atherosc lerosis. Since the immune response to HSPs can be modulated, this opens lip the possibility of new therapeutic approaches.