What is in common between preeclampsia, HPS70 and medieval headwear? Part II. Serum HSP70 in superimposed preeclampsia: original study
Authors: Popel O.K. , Govsieiev D.O. 
Published: May 2024

The objective: to investigate serum heat shock protein 70 (HSP70) concentration in pregnant women with chronic hypertension and superimposed preeclampsia. To assess the prospects of using HSP70 as a superimposed preeclampsia predictor.Materials and methods. The original prospective cohort single-center observational study included 105 pregnant women with chronic hypertension and 34 healthy pregnant women as a control group. Serum HSP70 was measured via enzyme-linked immunosorbent assay. The first measurement point of serum HSP70 was at 28 weeks of gestation, the second measurement point was at 36 weeks in case of absence of preeclampsia or at 29-35 weeks in case of preeclampsia. If signs of preeclampsia appeared later than 36 weeks, additional HSP70 measurement was not performed. Statistical analysis was conducted using EZR 1.55 software.Results. In the study group (105 pregnant women with chronic hypertension), after delivery 30 patients had signs of superimposed preeclampsia (superimposed preeclampsia subgroup) and 75 persons had no signs of superimposed preeclampsia (chronic hypertension subgroup). In the control group (34 healthy pregnant women) 3 patients after delivery had preeclampsia signs (preeclampsia subgroup) and another 31 had no signs of preeclampsia (healthy subgroup).Serum HSP70 levels, obtained at the first measurement point (28 weeks) was statistically significantly different between three subgroups: patients with chronic hypertension vs. patients with superimposed preeclampsia (p<0.01), healthy pregnant women vs. chronic hypertension women (p<0.0001), healthy persons vs. superimposed preeclampsia persons (p<0.0001).Serum HSP70 concentrations at the second measurement point (36 weeks, or 29-35 weeks in case of preeclampsia) also had a statistically significant difference for each pair of subgroups (p<0.001). Given the small number of persons in the preeclampsia subgroup (3 women), it was not included in the calculations.No statistically significant difference between serum HSP70 levels in the first and second measurement points was found in healthy pregnant women subgroup. In the subgroup of pregnant women with chronic hypertension without superimposed preeclampsia complications, a statistically significant increased serum HSP70 concentration was found at 36 weeks compared to 28 weeks (p<0.0001). Even bigger growth of HSP70 levels compared to 28 weeks occurred in case of joining preeclampsia to chronic hypertension (p<0.0001).Conclusions. The data suggest an increased concentration of HSP70 in pregnant women with superimposed preeclampsia compared to pregnant women with chronic hypertension of the corresponding term. Thus, it is possible to assume that HSP70 plays a role in superimposed preeclampsia pathogenesis.The increased serum HSP70 levels in pregnant women with chronic hypertension, compared to healthy pregnant women of the corresponding gestational age was determined. Therefore, it can be argued that HSP70 has an influence on the course of chronic hypertension during pregnancy.No statistically significant dependance of serum HSP70 level in healthy pregnant women on gestational age was found. The increase in the level of HSP70 in pregnant women with chronic hypertension with increasing gestational age is most likely due to the progression of hypertensive disorders and/or related conditions. The highest HSP70 increase was observed in pregnant women with chronic hypertension with the addition of preeclampsia.The use of HSP70 as the only predictor of superimposed preeclampsia is not effective, given its non-specificity, but the use of this indicator in combination with other markers is promising and requires further study.