Circulating Biomarkers of Collagen Metabolism in Cardiac Diseases
Circulating Biomarkers of Collagen Metabolism in Cardiac Diseases
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DOI：
10.1161/circulationaha.109.912774
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发表时间：
2010-04-13
期刊：
影响因子：
37.8
通讯作者：
Diez, Javier
中科院分区：
文献类型：
--
作者：
Lopez, Begona;Gonzalez, Arantxa;Diez, Javier
心肌的心肌细胞和非心肌细胞区室的结构和组成的改变似乎在与许多心脏疾病相关的心力衰竭（HF）的发病机制中起着中心作用。在这些改变中，细胞外基质（包括胶原网络）的数量和质量的变化已被表征为诱导心肌重塑并最终恶化左心室（LV）功能并促进HF的发展。胶原代谢的循环生物标志物的研究已经引起了医学界的关注，并且已经提出一些循环生物标志物作为改善发展HF的心脏疾病的诊断、预后和治疗的潜在有用工具。[1]然而，现有的数据还远远不是结论性的，也不能为更经典的诊断工具提供更多的知识。这主要是由于三个限制。首先，胶原蛋白是体内最丰富的蛋白质，其周转是如此动态，以至于并非所有被提议作为生物标志物的循环分子实际上都反映了胶原蛋白代谢的变化，即在心脏水平。其次，在研究中的心脏疾病中，对给定生物标志物与胶原蛋白网络的病理特征的关联的透彻理解并不被认为是必不可少的，从而削弱了其病理生理学意义。第三，几个方法学问题可能会引入一些混杂因素的胶原代谢的循环生物标志物的测量，从而使问题的有效性的可用结果。因此，这篇文章的目的不是提供一个系统的审查，所有已发表的信息循环的胶原代谢的生物标志物在心脏疾病，但在分析的生化，病理生理学和方法学方面要考虑到克服上述限制，提高这些分子的临床应用。
Alterations of the structure and composition of cardio-myocyte and noncardiomyocyte compartments of the myocardium appear to play a central role in the pathogenesis of heart failure (HF) associated with a number of cardiac diseases. Among these alterations, changes in the quantity and quality of the extracellular matrix, including the collagen network, have been characterized that induce remodeling of the myocardium and ultimately deteriorate left ventricular (LV) function and facilitate the development of HF. Studies on circulating biomarkers of collagen metabolism have attracted the attention of the medical community, and some circulating biomarkers have been proposed as potential useful tools to improve diagnosis, prognosis, and therapy in cardiac diseases that develop HF. 1 However, the available data are far from conclusive and from affording incremental value to the knowledge provided by more classic diagnostic tools. This is due mainly to 3 limitations. First, collagen is the most abundant protein in the body, and its turnover is so dynamic that not all circulating molecules proposed as biomarkers actually reflect changes in collagen metabolism, namely at the cardiac level. Second, a thorough understanding of the association of a given biomarker with the pathological features of the collagen network in the cardiac disease under study has not been considered essential, thus weakening its pathophysiological meaning. Third, several methodological issues may introduce a number of confounding factors into the measurements of circulating biomarkers of collagen metabolism, thus bringing into question the validity of the available results. Therefore, this article is not aimed at providing a systematic review of all the published information on circulating biomarkers of collagen metabolism in cardiac diseases but at analyzing the biochemical, pathophysiological, and methodological aspects to be taken into account to overcome the above limitations and to improve the clinical applicability of such molecules.