Polymorphonuclear neutrophils (PMN), through their ability to release oxygen-free radicals and other tissue-damaging molecules, play a major role in the pathogenesis of multiple organ failure syndrome (MOFS). There is evidence that heat shock proteins (stress proteins; HSPs) are involved in cellular repair mechanisms, and are protecting cells against oxidative injury. In this study, we analyzed the spontaneous expression of the 72 kD HSP (HSP72) in peripheral blood PMN of 20 critically ill patients (16 polytrauma victims, four patients after major surgery) admitted to an intensive care unit. The expression of HSP72 was investigated in PMN of patients and healthy donors by immunohistochemistry. We found spontaneous expression of HSP72 in PMN of 12 (60%) of 20 patients. No specific staining was detected in PMN of healthy donors (n = 10). In PMN of six of 12 patients expressing HSP72 without previous heat treatment, we found an impairment of respiratory burst activity (RBA) compared to the control population. These results demonstrate for the first time the in vivo expression of HSP72 in human leukocytes without previous heat treatment, and suggest a possible role of this protein in patients suffering from severe tissue injury.