The role of heat shock proteins in fracture healing—a narrative review

Fracture healing is a physiological process that is always accompanied by an immunologically mediated inflammatory reaction, resulting in primary bone healing. Heat shock proteins (HSPs) are omnipresent stress proteins produced by cells in response to exposure to stressful conditions, which function as intracellular proteins that accomplish protein folding and transport intracellularly. This narrative review aims to shed light on the underlying molecular mechanisms of HSPs with respect to the currently available Medline literature. The initial search for “heat shock protein AND fracture” identified 70 studies; after reviewing the texts and checking for content, 9 studies remained. The second search for “heat shock protein AND trauma AND bone” identified 67 studies. After manually searching through the titles and abstracts, six articles remained, three of which were already found in the first search. One study was excluded because it did not include HSPs or fractures, resulting in two additional papers being included. The third search for “heat shock protein AND osteogenesis imperfecta AND fracture” resulted in nine studies. After reviewing the texts, three articles that were already included from the first search remained. This review highlights the significant potential of HSPs and the established HSP investigations related to fracture healing. Our review indicates that, despite the few studies available, those that were selected are very important for identifying research approaches and areas that require further study.