Biomarkers in Pulmonary Vascular Disease: Gauging Response to Therapy.
Biomarkers in Pulmonary Vascular Disease: Gauging Response to Therapy.
复制标题
肺血管疾病的生物标志物：衡量治疗反应。
DOI：
10.1016/j.amjcard.2017.06.014
复制
发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Bryan,NathanS
中科院分区：
文献类型：
--
作者：
McMahon,TimothyJ;Bryan,NathanS
越来越多的生物标志物在肺血管疾病的治疗中得到研究。特别是，肺动脉高压治疗所针对的信号通路提供了生物标志物，这些生物标志物可能可用于指导治疗和评估临床反应，作为右侧心导管插入术等侵入性手术的替代方案。此外，越来越多地使用联合疗法来治疗肺动脉高压的初始和后续治疗，这凸显了这种治疗方法中对生物标志物的需求。目前批准的肺动脉高压疗法主要针对 3 种信号传导途径：一氧化氮可溶性鸟苷酸环化酶-环单磷酸鸟苷途径、内皮素途径和前列环素途径。虽然实践中使用和临床试验评估的主要生物标志物是N端脑钠肽前体，但其他假定的生物标志物包括内源性一氧化氮（NO）合酶抑制剂不对称二甲基精氨酸、NO代谢物（包括S-亚硝基硫醇和亚硝酸盐）、呼出一氧化氮、内皮素、环磷酸鸟苷、环磷酸腺苷和心房钠尿肽。这篇综述描述了与当前治疗的实际靶向分子相关的可访问的生物标志物，用于测量和预测对个体肺动脉高压治疗类别以及联合治疗的反应。
Biomarkers are increasingly being investigated in the treatment of pulmonary vascular disease. In particular, the signaling pathways targeted by therapies for pulmonary arterial hypertension provide biomarkers that potentially can be used to guide therapy and to assess clinical response as an alternative to invasive procedures such as right-sided cardiac catheterization. Moreover, the growing use of combination therapy for both the initial and subsequent treatment of pulmonary arterial hypertension highlights the need for biomarkers in this treatment approach. Currently approved therapies for pulmonary arterial hypertension target 3 major signaling pathways: the nitric oxide-soluble guanylate cyclase-cyclic guanosine monophosphate pathway, the endothelin pathway, and the prostacyclin pathway. Although the main biomarker used in practice and evaluated in clinical trials is N-terminal pro-brain natriuretic peptide, other putative biomarkers include the endogenous nitric oxide (NO) synthase inhibitor asymmetric dimethylarginine, NO metabolites includingS-nitrosothiols and nitrite, exhaled NO, endothelins, cyclic guanosine monophosphate, cyclic adenosine monophosphate, and atrial natriuretic peptide. This review describes accessible biomarkers, related to the actual molecules targeted by current therapies, for measuring and predicting response to the individual pulmonary arterial hypertension treatment classes as well as combination therapy.