Surface expression of heat shock proteins in some connective tissue diseases and its relation to the clinical manifestations

الملخص EN

Material: The present work was performed on 32 patients classified into 3 groups according to their diagnosis: Group I: included 12 RA patients, 9 females and 3 males, whose age ranged from 24 to 52 years, with disease duration 2 to 11 years.

The patients were assessed clinically to obtain MDAG and radiologically using the hand’s Larsen’s stage modified by Rau and Herborn.

Group II: included 12 SLE patients, all females their age ranged from 20 to 37 years and disease duration 1 to 6 years.

The patients were assessed clinically for analyzing the disease activity using the British Isles Lupus Assessment Group (BILAG) system.

Group III: included 8 SSc patients, 7 females and 1 male with an age that ranged from 25 to 40 years and disease duration of 2 to 10 years.

Five patients had the localized type (Morphea) and 3 had diffuse type.

All the patients were examined clinically and skin thickness assessed to obtain total skin score.

Group IV: Controls comprised 10 healthy subjects age and sex matched with the patients.

Methods: The patient’s treatment at the time of measurement was noted to determine whether steroids have any effect on the level of expression of hsp 90 or not.

So each group was subdivided into: patients taking no steroids; taking steroids alone or steroids with other immuno-suppressives.

The following laboratory investigations were done for the patients and control group: CBC, ESR, CRP, RF titer, protein in urine, anti-ds DNA and detection of hsp 70, 90, ubiquitin using flow cytometry.

Results: Surface expression of both hsp 70, 90 showed a significant difference in the various groups of the study as compared with the control group (p<0.001).

But ubiquitin didn’t show any significant difference.

The increase in both hsp 70, 90 showed a significant association with the various clinical manifestations in each group of patients and they didn’t increase parallel with each other (p>0.05).

This strongly suggests that there may be a difference in the way those genes are regulated in patients that are responsible for the expression pattern and guide for the role of each specific hsp in the etiology and pathogenesis of each disease.

Also for the future use of novel immunotherapies targeted to T cells with specificity for heat shock proteins to be effective in suppressing disease process.