HSPA5 and metabolic syndrome: However, the specificity might be low due to induction of GRP78 in other stress settings, such as pulmonary arterial hypertension,[7] rheumatoid arthritis,[27, 28, 29] obesity and metabolic syndrome,[30, 31] as well as other types of tumors.[5] In our investigation, it was also observed that serum sGRP78 was significantly elevated in breast cancer patients receiving neoadjuvant therapy, especially after 4th round of chemotherapy (quantified as “sGRP78 index”).