Elevated anti-heat shock protein 60 antibody titer is related to white matter hyperintensities

There are many reports that the antibody against heat shock protein 60 (Hsp60) is present in most patients with coronary artery disease and atherosclerosis, and that its titer correlates with disease severity. However, few reports have described the association between anti-Hsp60 antibody and cerebrovascular disease.

We determined the anti-Hsp60 antibody titer in patients with neurologic diseases and healthy subjects using enzyme-linked immunosorbent assay (ELISA) and evaluated their findings of brain magnetic resonance imaging (MRI) of the white matter. White matter hyperintensities (WMHs) on T2-weighted and fluid-attenuated inversion recovery (FLAIR) images were classified into 2 categories: periventricular hyperintensity (PVH) and deep white matter hyperintensity (DWMH). The lesions in each category were then divided into 4 grades (grades 0-3) according to the Fazekas rating scale.

There were no significant differences in the titer between patients with neurologic diseases and healthy subjects. The mean grade of DWMHs (mean ± SD, 1.56 ± 0.70) was significantly higher in 18 subjects in the high-titer group (≥39.8 ng/mL; mean titer + 2 SD in sera from 23 healthy subjects) than in 86 subjects (mean ± SD, 0.09 ± 0.76) in the normal-titer group (<39.8 ng/mL; P < .003). The mean grade of PVHs (mean ± SD, 1.50 ± 0.71) was also significantly higher in the high-titer group than in the normal-titer group (mean ± SD, 1.17 ± 0.62; P < .02).

A significant correlation was noted between anti-Hsp60 antibody titer and the severity of WMHs on brain MR images. We suggest that an elevated titer of the anti-Hsp60 antibody could be a risk factor for cerebral small-vessel disease.