Exertional heat illness is a potentially fatal disorder that primarily affects fit young men. Plasma Hsp72 may be important in the aetiology of this disorder, acting as a danger signal to the organism and leading to an inflammatory response. The aim of this study was to determine whether patients with exertional heat illness following a 14 km run show a difference in their plasma Hsp72 concentration compared with control subjects who completed the event without incident. Patients (n = 22) and controls (n = 7) were all male. The patients were subdivided into two groups, one of which exhibited more serious symptoms indicating neurological impairment such as confusion (n = 13) (CNS) while the other group exhibited mild symptoms (MILD) (n = 9). The CNS group had a higher rectal temperature (T(rec)) compared with the control group (41.0 +/- 0.3 vs. 39.8 +/- 0.2 degrees C, P < 0.05, mean +/- SE). Immediately after the run plasma Hsp72 was higher in the CNS group compared to controls and patients with mild symptoms (37.9, 17.0, and 20.9 ng/ml, respectively, P < 0.005). There was a correlation between plasma Hsp72 and T(rec) measured immediately after the race (r = 0.597, P < 0.001, n = 29). However, core temperature was not the only factor leading to increased plasma Hsp72 immediately post race. Plasma Hsp72 was still higher in CNS patients compared with the control group (P < 0.05) when T(rec )was included as a covariate. In conclusion, plasma Hsp72 was elevated immediately after a 14 km run with higher levels in patients with more serious symptoms of heat illness.
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