Up-regulation of HSPA1A and HSPA1B in the blood of tophi patients and its clinical significance

Objective: Poorly treated gout can cause tophi, which can lead to serious and potentially fatal complications. This study aimed to find the potential diagnostic value of blood levels of HSPA1A and HSPA1B for tophi patients. Methods: 58 tophi patients and 61 healthy controls were enrolled in this study, and the whole venous blood samples of all subjects were collected for microarray analysis to identify differentially expressed genes associated with tophi. Meanwhile, KEGG and GO analysis were used to filtrate the enriched different expression genes. The mRNA expression levels of HSPA1A, as well as HSPA1B, were measured by the RT-qPCR method, the correlation between which and the severity of the disease were analyzed. Finally, the receiver operating characteristics curve (ROC) analysis has been performed to the diagnostic value of HSPA1A as well as HSPA1B. Results: Bioinformatic analysis results suggested that both HSPA1A and HSPA1B are abnormally expressed in tophi. Then, it was observed that HSPA1A and HSPA1B were dramatically increased in the blood samples of tophi patients compared with healthy controls and were further linked with the severity of tophi. Moreover, the area under the curve (AUC) of HSPA1A for the diagnosis of ACI was 0.8999 (95% confidence interval (CI), 0.8338 to 0.9661) while of HSPA1B was 0.9093 (95% confidence interval (CI), 0.8550 to 0.9635), suggesting that blood level of HSPA1A, as well as HSPA1B, are sensitive markers to distinguish tophi patients from the healthy people. Conclusion: HSPA1A and HSPA1B were over-expressed in the blood of tophi patients and may be potential diagnostic markers for tophi.