1
|
Carella M, Magro D, Scola L, Pisano C, Guida E, Gervasi F, Giambanco C, Aronica TS, Frati G, Balistreri CR. CAR, mGPS and hs-mGPS: What is among them the best gero-biomarker for age-related diseases? And for what clinical application? Mech Ageing Dev 2024; 220:111952. [PMID: 38838917 DOI: 10.1016/j.mad.2024.111952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 05/21/2024] [Accepted: 05/26/2024] [Indexed: 06/07/2024]
Abstract
The identification of biomarkers linked to the onset, progression, and prevention of age-related diseases (ARD), in the era of personalized medicine, represents the best goal of geroscience. Geroscience has the fundamental role of exploring and identifying the biological mechanisms of aging to suggest interventions capable of stopping/delaying the many pathological conditions and disabilities related to age. Therefore, it has become its key priority, as well as that of clinical practice and research, based on identifying and validating a range of biomarkers, geromarkers, which can be used to diagnostic, prognostic, or predictive clinical purposes. Indeed, geromarkers have, the potential to predict ARD trajectories and facilitate targeted interventions to slow down the related disabilities. Here our attention is paid to the inflammatory indexes (CAR, mGPS, hs-mGPS) linked to the relationship between the plasma levels of two inflammatory analytes, the typical positive protein of the acute phase, and the negative one, i.e. c-reactive protein (CRP) and albumin, respectively. These indexes allow us to understand the magnitude of the two main mechanisms predicted to influence the aging process, including inflammation and immunosenescence, as well as the degree of ARD severity. Evidence on their relationship with ARD is widely reported and discussed, to understand which can represent the best ARD geromarker, and its clinical application.
Collapse
Affiliation(s)
- Miriam Carella
- Complex Operative Unit of Clinical Pathology, ARNAS Civico Di Cristina e Benfratelli Hospitals, Palermo 90127, Italy
| | - Daniele Magro
- Cellular, Molecular and Clinical Pathological Laboratory, Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University of Palermo, Palermo 90134, Italy
| | - Letizia Scola
- Cellular, Molecular and Clinical Pathological Laboratory, Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University of Palermo, Palermo 90134, Italy
| | - Calogera Pisano
- Department of Precision Medicine in Medicine, Surgery, Critical Areas, University of Palermo, Palermo 90127, Italy
| | - Eugenia Guida
- Specialized Laboratory of Oncology, ARNAS Civico Di Cristina e Benfratelli Hospitals, Palermo 90127, Italy
| | - Francesco Gervasi
- Specialized Laboratory of Oncology, ARNAS Civico Di Cristina e Benfratelli Hospitals, Palermo 90127, Italy
| | - Caterina Giambanco
- Complex Operative Unit of Clinical Pathology, ARNAS Civico Di Cristina e Benfratelli Hospitals, Palermo 90127, Italy
| | - Tommaso Silvano Aronica
- Complex Operative Unit of Clinical Pathology, ARNAS Civico Di Cristina e Benfratelli Hospitals, Palermo 90127, Italy
| | - Giacomo Frati
- IRCCS Neuromed, Pozzilli, Italy; Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
| | - Carmela Rita Balistreri
- Cellular, Molecular and Clinical Pathological Laboratory, Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University of Palermo, Palermo 90134, Italy.
| |
Collapse
|
2
|
Khan H, Abu-Raisi M, Feasson M, Shaikh F, Saposnik G, Mamdani M, Qadura M. Current Prognostic Biomarkers for Abdominal Aortic Aneurysm: A Comprehensive Scoping Review of the Literature. Biomolecules 2024; 14:661. [PMID: 38927064 PMCID: PMC11201473 DOI: 10.3390/biom14060661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 05/29/2024] [Accepted: 06/03/2024] [Indexed: 06/28/2024] Open
Abstract
Abdominal aortic aneurysm (AAA) is a progressive dilatation of the aorta that can lead to aortic rupture. The pathophysiology of the disease is not well characterized but is known to be caused by the general breakdown of the extracellular matrix within the aortic wall. In this comprehensive literature review, all current research on proteins that have been investigated for their potential prognostic capabilities in patients with AAA was included. A total of 45 proteins were found to be potential prognostic biomarkers for AAA, predicting incidence of AAA, AAA rupture, AAA growth, endoleak, and post-surgical mortality. The 45 proteins fell into the following seven general categories based on their primary function: (1) cardiovascular health, (2) hemostasis, (3) transport proteins, (4) inflammation and immunity, (5) kidney function, (6) cellular structure, (7) and hormones and growth factors. This is the most up-to-date literature review on current prognostic markers for AAA and their functions. This review outlines the wide pathophysiological processes that are implicated in AAA disease progression.
Collapse
Affiliation(s)
- Hamzah Khan
- Division of Vascular Surgery, St. Michael’s Hospital, Toronto, ON M5B 1W8, Canada
- Li Ka Shing Knowledge Institute, St Michael’s Hospital, Unity Health Toronto, Toronto, ON M5B 1W8, Canada
| | - Mohamed Abu-Raisi
- Division of Vascular Surgery, St. Michael’s Hospital, Toronto, ON M5B 1W8, Canada
- Li Ka Shing Knowledge Institute, St Michael’s Hospital, Unity Health Toronto, Toronto, ON M5B 1W8, Canada
| | - Manon Feasson
- Li Ka Shing Knowledge Institute, St Michael’s Hospital, Unity Health Toronto, Toronto, ON M5B 1W8, Canada
| | - Farah Shaikh
- Division of Vascular Surgery, St. Michael’s Hospital, Toronto, ON M5B 1W8, Canada
- Li Ka Shing Knowledge Institute, St Michael’s Hospital, Unity Health Toronto, Toronto, ON M5B 1W8, Canada
| | - Gustavo Saposnik
- Li Ka Shing Knowledge Institute, St Michael’s Hospital, Unity Health Toronto, Toronto, ON M5B 1W8, Canada
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Muhammad Mamdani
- Li Ka Shing Knowledge Institute, St Michael’s Hospital, Unity Health Toronto, Toronto, ON M5B 1W8, Canada
| | - Mohammad Qadura
- Division of Vascular Surgery, St. Michael’s Hospital, Toronto, ON M5B 1W8, Canada
- Li Ka Shing Knowledge Institute, St Michael’s Hospital, Unity Health Toronto, Toronto, ON M5B 1W8, Canada
- Department of Surgery, University of Toronto, Toronto, ON M5T 1P5, Canada
| |
Collapse
|
3
|
Fu Y, Liu H, Li K, Wei P, Alam N, Deng J, Li M, Wu H, He X, Hou H, Xia C, Wang R, Wang W, Bai L, Xu B, Li Y, Wu Y, Liu E, Zhao S. C-reactive protein deficiency ameliorates experimental abdominal aortic aneurysms. Front Immunol 2023; 14:1233807. [PMID: 37753091 PMCID: PMC10518468 DOI: 10.3389/fimmu.2023.1233807] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 08/25/2023] [Indexed: 09/28/2023] Open
Abstract
Background C-reactive protein (CRP) levels are elevated in patients with abdominal aortic aneurysms (AAA). However, it has not been investigated whether CRP contributes to AAA pathogenesis. Methods CRP deficient and wild type (WT) male mice were subjected to AAA induction via transient intra-aortic infusion of porcine pancreatic elastase. AAAs were monitored by in situ measurements of maximal infrarenal aortic external diameters immediately prior to and 14 days following elastase infusion. Key AAA pathologies were assessed by histochemical and immunohistochemical staining procedures. The influence of CRP deficiency on macrophage activation was evaluated in peritoneal macrophages in vitro. Results CRP protein levels were higher in aneurysmal than that in non-aneurysmal aortas. Aneurysmal aortic dilation was markedly suppressed in CRP deficient (aortic diameter: 1.08 ± 0.11 mm) as compared to WT (1.21 ± 0.08 mm) mice on day 14 after elastase infusion. More medial elastin was retained in CRP deficient than in WT elastase-infused mice. Macrophage accumulation was significantly less in aneurysmal aorta from CRP deficient than that from WT mice. Matrix metalloproteinase 2 expression was also attenuated in CRP deficient as compared to WT aneurysmal aortas. CRP deficiency had no recognizable influence on medial smooth muscle loss, lymphocyte accumulation, aneurysmal angiogenesis, and matrix metalloproteinase 9 expression. In in vitro assays, mRNA levels for tumor necrosis factor α and cyclooxygenase 2 were reduced in lipopolysaccharide activated peritoneal macrophages from CRP deficient as compared to wild type mice. Conclusion CRP deficiency suppressed experimental AAAs by attenuating aneurysmal elastin destruction, macrophage accumulation and matrix metalloproteinase 2 expression.
Collapse
Affiliation(s)
- Yu Fu
- Institute of Cardiovascular Science, Translational Medicine Institute, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Haole Liu
- Institute of Cardiovascular Science, Translational Medicine Institute, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Kexin Li
- Institute of Cardiovascular Science, Translational Medicine Institute, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Panpan Wei
- Institute of Cardiovascular Science, Translational Medicine Institute, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Naqash Alam
- Institute of Cardiovascular Science, Translational Medicine Institute, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Jie Deng
- Department of Cardiology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Meng Li
- Department of Vascular Surgery, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Haibin Wu
- Institute of Cardiovascular Science, Translational Medicine Institute, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Xue He
- Institute of Cardiovascular Science, Translational Medicine Institute, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Haiwen Hou
- Institute of Cardiovascular Science, Translational Medicine Institute, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Congcong Xia
- Institute of Cardiovascular Science, Translational Medicine Institute, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Rong Wang
- Institute of Cardiovascular Science, Translational Medicine Institute, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Weirong Wang
- Institute of Cardiovascular Science, Translational Medicine Institute, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Liang Bai
- Institute of Cardiovascular Science, Translational Medicine Institute, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Baohui Xu
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, United States
| | - Yankui Li
- Department of Vascular Surgery, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Yi Wu
- Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi’an, Shaanxi, China
| | - Enqi Liu
- Institute of Cardiovascular Science, Translational Medicine Institute, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Sihai Zhao
- Institute of Cardiovascular Science, Translational Medicine Institute, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
- Department of Cardiology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China
| |
Collapse
|
4
|
Kasprzak MP, Gryszczyńska B, Olasińska-Wiśniewska A, Urbanowicz T, Jawień A, Krasiński Z, Formanowicz D. Blb-NRF2-PON1 Cross-Talk in Abdominal Aortic Aneurysm Progression. Antioxidants (Basel) 2023; 12:1568. [PMID: 37627563 PMCID: PMC10451880 DOI: 10.3390/antiox12081568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/02/2023] [Accepted: 08/04/2023] [Indexed: 08/27/2023] Open
Abstract
The progression of an abdominal aortic aneurysm (AAA) is an important issue, especially as AAA is becoming more common, and potentially life-threatening. This study aimed to understand better the mechanisms underlying AAA progression. For this purpose, we have focused on assessing the selected biomarkers whose potentially common denominator is the NRF2 (nuclear factor erythroid 2-related factor 2) transcription factor, that determines the selected antioxidant enzymes' activation. The study group consisted of 44 AAA male patients (71.41 ± 7.80 years aged). They were divided into three groups based on the aneurism diameter: group I (below 55 mm), group II (between 55 and 70 mm), and group III (over 70 mm). The laboratory analyses of PON1 (paraoxonase-1), NRF2, and HO-1 (heme oxygenase 1) were performed based on commercial ELISA tests; Blb (bilirubin) and hsCRP (high sensitivity C-reactive protein) were assessed during routine morphology examinations after admission to the hospital. Multiple linear regression showed that both bilirubin and NRF2 determined the PON1 concentration in the entire study group. The correlations between the examined parameters within the three studied groups suggest the capitulation of NRF2-dependent antioxidant mechanisms to pro-inflammatory processes. We showed that HO-1 and hsCRP may play a crucial role in the development of inflammation aneurism progression. Moreover, in patients with medium-sized aneurysms, antioxidant mechanisms were depressed, and inflammatory processes began to dominate, which may lead to uncontrolled growth aneurysm rupture. Our study is one of the first to indicate that the chronically activated antioxidant pathway using NRF2 may be a source of reduction stress.
Collapse
Affiliation(s)
- Magdalena P. Kasprzak
- Department of Medical Chemistry and Laboratory Medicine, Poznan University of Medical Sciences, Rokietnicka 8, 60-806 Poznan, Poland
| | - Bogna Gryszczyńska
- Department of Medical Chemistry and Laboratory Medicine, Poznan University of Medical Sciences, Rokietnicka 8, 60-806 Poznan, Poland
| | - Anna Olasińska-Wiśniewska
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, 61-701 Poznan, Poland
| | - Tomasz Urbanowicz
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, 61-701 Poznan, Poland
| | - Andrzej Jawień
- Department of Vascular and Endovascular Surgery Angiology and Phlebology, Poznan University of Medical Sciences, 61-701 Poznan, Poland
| | - Zbigniew Krasiński
- Department of Vascular and Endovascular Surgery Angiology and Phlebology, Poznan University of Medical Sciences, 61-701 Poznan, Poland
| | - Dorota Formanowicz
- Department of Medical Chemistry and Laboratory Medicine, Poznan University of Medical Sciences, Rokietnicka 8, 60-806 Poznan, Poland
- Department of Stem Cells and Regenerative Medicine, Institute of Natural Fibres and Medicinal Plants-National Research, Kolejowa 2, 62-064 Plewiska, Poland
| |
Collapse
|
5
|
Huanggu H, Yang D, Zheng Y. Blood immunological profile of abdominal aortic aneurysm based on autoimmune injury. Autoimmun Rev 2023; 22:103258. [PMID: 36563768 DOI: 10.1016/j.autrev.2022.103258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 12/18/2022] [Indexed: 12/24/2022]
Abstract
Abdominal aortic aneurysm (AAA) occupies a large part of aorta aneurysm, and if there's no timely intervention or treatment, the risks of rupture and death would rise sharply. With the depth of research in AAA, more and more evidence showed correlations between AAA and autoimmune injury. Currently, a variety of bioactive peptides and cells have been confirmed to be related with AAA progression. Despite the tremendous progress, more than half researches were sampling from lesion tissues, which would be difficult to obtain. Given that the intrusiveness and convenience, serological test take advantages in initial diagnosis. Here we review blood biomarkers associated with autoimmune injury work in AAA evolution, aiming to make a profile on blood immune substances of AAA and provide a thought for potential clinical practice.
Collapse
Affiliation(s)
- Haotian Huanggu
- Department of Vascular Surgery, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing, China
| | - Dan Yang
- Department of Computational Biology and Bioinformatics, Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuehong Zheng
- Department of Vascular Surgery, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing, China; Department of Vascular Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
| |
Collapse
|
6
|
Dolapoglu A, Avci E, Kiris T. The predictive value of C-reactive protein to albümin ratio for ascending aort progression in patients with ascending aortic diameter of 40-50 mm. J Cardiothorac Surg 2022; 17:254. [PMID: 36195877 PMCID: PMC9533617 DOI: 10.1186/s13019-022-02003-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 09/24/2022] [Indexed: 11/10/2022] Open
Abstract
We aimed to investigate the ability of the C-reactive protein-to-albumin ratio (CAR) to predict ascending aorta progression in patients with 40-50 mm diameter of ascending aortic dilatation. A total of 182 diagnosed patients with ascending aortic diameters of 40-50 mm were enrolled in this study. The study population was divided into tertiles based on yearly ascending aortic growth rate values. Group I (n = 137) was defined as a value in the lower 2 tertiles (ascending aorta growth ≤ 1.00 mm/year), and group II (n = 45) was defined as a value in the third tertile (ascending aorta growth > 1.00 mm/year). Hypertension, chronic obstructive pulmonary disease, positive family history, and CAR were found to be independent risk factors for ascending aorta growth > 1.00 mm/year. The area under the ROC curve (AUC) of CAR was 0.771(95% CI 0.689-0.854) for predicting ascending aorta growth > 1.00 mm/year. In patients with 40-50 mm ascending aneurysms, CAR may be useful to predict ascending aorta progression.
Collapse
Affiliation(s)
- Ahmet Dolapoglu
- Department of Cardiovascular Surgery, Balikesir University Medical Faculty, Balıkesir, Turkey
| | - Eyüp Avci
- Department of Cardiology, Balikesir University Medical School, Balıkesir, Turkey
| | - Tuncay Kiris
- Department of Cardiology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey.
| |
Collapse
|
7
|
Kim BG, Seo J, Kim GS, Jin MN, Lee HY, Byun YS, Kim BO. Elevated C-Reactive Protein/Albumin Ratio Is Associated With Lesion Complexity, Multilevel Involvement, and Adverse Outcomes in Patients With Peripheral Artery Disease. Angiology 2022; 73:843-851. [PMID: 35236141 DOI: 10.1177/00033197221075853] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Inflammation plays an important role in the progression of peripheral artery disease (PAD). We investigated the predictive value of the C-reactive protein-to-albumin ratio (CAR) on the severity of PAD and outcomes after endovascular therapy (EVT). Patients (n = 307) with PAD who underwent EVT were retrospectively reviewed and categorized according to CAR tertiles. The groups were compared for the prevalence of complex lesions and multilevel involvement as well as the incidence of major adverse cardiovascular events (MACEs) and major adverse limb events (MALEs). The rates of complex lesions and multilevel involvement increased with increasing CAR tertiles (all P < .001). These associations remained significant even after adjustment for other confounders (complex lesion odds ratio, 1.22 [1.03-1.50]; P = .036; multilevel disease odds ratio, 1.20 [1.01-1.44]; P = .041). The third CAR tertile showed a significantly higher incidence of MACEs and MALEs than the second and first tertiles within a year (log-rank P < .001). A higher CAR as a continuous variable was also independently associated with the 4-year rate of MACE (hazard ratio, 1.20 [1.04-1.38]; P = .015). Elevated CAR was a powerful surrogate marker of severe PAD and worse outcomes. Thus, CAR might become a predictor of poor prognosis in patients with PAD.
Collapse
Affiliation(s)
- Byung Gyu Kim
- Division of Cardiology, Department of Internal Medicine, 65509Inje University College of Medicine, Sanggye Paik Hospital, Seoul, Korea
| | - Jongkwon Seo
- Division of Cardiology, Department of Internal Medicine, 65509Inje University College of Medicine, Sanggye Paik Hospital, Seoul, Korea
| | - Gwang Sil Kim
- Division of Cardiology, Department of Internal Medicine, 65509Inje University College of Medicine, Sanggye Paik Hospital, Seoul, Korea
| | - Moo-Nyun Jin
- Division of Cardiology, Department of Internal Medicine, 65509Inje University College of Medicine, Sanggye Paik Hospital, Seoul, Korea
| | - Hye Young Lee
- Division of Cardiology, Department of Internal Medicine, 65509Inje University College of Medicine, Sanggye Paik Hospital, Seoul, Korea
| | - Young Sup Byun
- Division of Cardiology, Department of Internal Medicine, 65509Inje University College of Medicine, Sanggye Paik Hospital, Seoul, Korea
| | - Byung Ok Kim
- Division of Cardiology, Department of Internal Medicine, 65509Inje University College of Medicine, Sanggye Paik Hospital, Seoul, Korea
| |
Collapse
|
8
|
Stilo F, Catanese V, Nenna A, Montelione N, Codispoti FA, Verghi E, Gabellini T, Jawabra M, Chello M, Spinelli F. Biomarkers in EndoVascular Aneurysm Repair (EVAR) and Abdominal Aortic Aneurysm: Pathophysiology and Clinical Implications. Diagnostics (Basel) 2022; 12:diagnostics12010183. [PMID: 35054350 PMCID: PMC8774611 DOI: 10.3390/diagnostics12010183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 01/10/2022] [Accepted: 01/11/2022] [Indexed: 12/16/2022] Open
Abstract
Circulating biomarkers have been recently investigated among patients undergoing endovascular aortic aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA). Considering the plethora of small descriptive studies reporting potential associations between biomarkers and clinical outcomes, this review aims to summarize the current literature considering both the treated disease (post EVAR) and the untreated disease (AAA before EVAR). All studies describing outcomes of tissue biomarkers in patients undergoing EVAR and in patients with AAA were included, and references were checked for additional sources. In the EVAR scenario, circulating interleukin-6 (IL-6) is a marker of inflammatory reaction which might predict postoperative morbidity; cystatin C is a promising early marker of post-procedural acute kidney injury; plasma matrix metalloproteinase-9 (MMP-9) concentration after 3 months from EVAR might help in detecting post-procedural endoleak. This review also summarizes the current gaps in knowledge and future direction of this field of research. Among markers used in patients with AAA, galectin and granzyme appear to be promising and should be carefully investigated even in the EVAR setting. Larger prospective trials are required to establish and evaluate prognostic models with highest values with these markers.
Collapse
Affiliation(s)
- Francesco Stilo
- Department of Vascular Surgery, Campus Bio-Medico University, 00128 Rome, Italy;
| | - Vincenzo Catanese
- Department of Vascular Surgery, Campus Bio-Medico University, 00128 Rome, Italy;
- Correspondence: or
| | - Antonio Nenna
- Department of Cardiovascular Surgery, Campus Bio-Medico University, 00128 Rome, Italy; (A.N.); (N.M.); (F.A.C.); (E.V.); (M.J.); (M.C.); (F.S.)
| | - Nunzio Montelione
- Department of Cardiovascular Surgery, Campus Bio-Medico University, 00128 Rome, Italy; (A.N.); (N.M.); (F.A.C.); (E.V.); (M.J.); (M.C.); (F.S.)
| | - Francesco Alberto Codispoti
- Department of Cardiovascular Surgery, Campus Bio-Medico University, 00128 Rome, Italy; (A.N.); (N.M.); (F.A.C.); (E.V.); (M.J.); (M.C.); (F.S.)
| | - Emanuele Verghi
- Department of Cardiovascular Surgery, Campus Bio-Medico University, 00128 Rome, Italy; (A.N.); (N.M.); (F.A.C.); (E.V.); (M.J.); (M.C.); (F.S.)
| | - Teresa Gabellini
- Residency Program of Vascular and Endovascular Surgery, University of Ferrara, 44121 Ferrara, Italy;
| | - Mohamad Jawabra
- Department of Cardiovascular Surgery, Campus Bio-Medico University, 00128 Rome, Italy; (A.N.); (N.M.); (F.A.C.); (E.V.); (M.J.); (M.C.); (F.S.)
| | - Massimo Chello
- Department of Cardiovascular Surgery, Campus Bio-Medico University, 00128 Rome, Italy; (A.N.); (N.M.); (F.A.C.); (E.V.); (M.J.); (M.C.); (F.S.)
| | - Francesco Spinelli
- Department of Cardiovascular Surgery, Campus Bio-Medico University, 00128 Rome, Italy; (A.N.); (N.M.); (F.A.C.); (E.V.); (M.J.); (M.C.); (F.S.)
| |
Collapse
|
9
|
Li T, Yang C, Jing J, Sun L, Yuan Y. Granzyme K - A novel marker to identify the presence and rupture of abdominal aortic aneurysm. Int J Cardiol 2021; 338:242-247. [PMID: 34139229 DOI: 10.1016/j.ijcard.2021.06.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/01/2021] [Accepted: 06/09/2021] [Indexed: 02/09/2023]
Abstract
BACKGROUND Immune inflammatory dysfunction is a hallmark of abdominal aortic aneurysm (AAA). Granzyme K (GZMK) is involved in the regulation of inflammation. However, the correlation between GZMK expression and AAA risk remains unknown. METHODS This case-control study included 112 AAA patients and 112 controls. Serum GZMK levels were determined by enzyme-linked immunosorbent assay and immunohistochemistry was utilized to determine GZMK expression in aortic tissues. RESULTS Compared with controls, AAA patients had higher levels of serum GZMK, and GZMK expression in AAA tissues was increased and positively associated with its serum levels (r = 0.688, P = 0.019). A positive association of serum GZMK levels with CRP or AAA diameter was confirmed, while there was a relationship between tissue GZMK expression and AAA diameter. The AUC of serum GZMK for AAA diagnosis was 0.78 with the sensitivity and specificity of 62.5% and 81.2%, whereas AUC for rupture detection was 0.76 with a sensitivity of 90.0% and specificity of 51.3%. A combination of clinically used inflammatory parameters with serum GZMK could enhance the accuracy of WBC or CRP alone in detecting AAA or rupture type. Multiple logistic analyses revealed an association of per unit increase of serum GZMK with AAA presence (OR = 1.046, P < 0.001) and its rupture risk (OR = 1.015, P = 0.048) after adjusting for confounding factors. CONCLUSIONS Our study provides proof that elevated GZMK expression both in serum and tissues is correlated with the presence of AAA, and serum GZMK may be a useful non-invasive marker that helps to identify AAA and its rupture risk in clinical practice.
Collapse
Affiliation(s)
- Tan Li
- Department of Cardiovascular Ultrasound, the First Hospital of China Medical University, Shenyang 110001, China; Tumor Etiology and Screening Department of Cancer Institute and General Surgery, the First Hospital of China Medical University, Shenyang 110001, China; Key Laboratory of Cancer Etiology and Prevention in Liaoning Education Department, the First Hospital of China Medical University, Shenyang 110001, China
| | - Chao Yang
- Trauma Center and Department of Burns, the First Hospital of China Medical University, Shenyang 110001, China
| | - Jingjing Jing
- Tumor Etiology and Screening Department of Cancer Institute and General Surgery, the First Hospital of China Medical University, Shenyang 110001, China; Key Laboratory of Cancer Etiology and Prevention in Liaoning Education Department, the First Hospital of China Medical University, Shenyang 110001, China
| | - Liping Sun
- Tumor Etiology and Screening Department of Cancer Institute and General Surgery, the First Hospital of China Medical University, Shenyang 110001, China; Key Laboratory of Cancer Etiology and Prevention in Liaoning Education Department, the First Hospital of China Medical University, Shenyang 110001, China
| | - Yuan Yuan
- Tumor Etiology and Screening Department of Cancer Institute and General Surgery, the First Hospital of China Medical University, Shenyang 110001, China; Key Laboratory of Cancer Etiology and Prevention in Liaoning Education Department, the First Hospital of China Medical University, Shenyang 110001, China.
| |
Collapse
|