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Desmosine and Isodesmosine as a Novel Biomarker for Pulmonary Arterial Hypertension: A Pilot Study. | LitMetric

Desmosine and Isodesmosine as a Novel Biomarker for Pulmonary Arterial Hypertension: A Pilot Study.

Am J Ther

Division of Pulmonary Critical Care and Sleep Medicine, Mount Sinai Roosevelt and Mount Sinai St. Luke's, New York, NY.

Published: April 2018

AI Article Synopsis

  • - Delayed diagnosis of pulmonary arterial hypertension (PAH) is common, with right-sided heart catheterization being the standard but not suitable for routine screening, leading to an ongoing search for effective biomarkers.
  • - The study focused on elastin turnover, measuring levels of the amino acids desmosine and isodesmosine (D&I) in plasma and urine to assess their potential as biomarkers for PAH.
  • - Results showed significantly higher levels of D&I in both plasma and urine in PAH patients compared to healthy controls, suggesting that D&I could be a promising novel biomarker for PAH, leading to further research on its use in disease assessment and treatment response.

Article Abstract

Delayed diagnosis is common in patients with pulmonary arterial hypertension (PAH). Right-sided heart catheterization, the gold standard for diagnosis, is invasive and cannot be applied for routine screening. Some biomarkers have been looked into; however, due to the lack of a clear pathological mechanism linking the marker to PAH, the search for an ideal one is still ongoing. Elastin is a significant structural constituent of blood vessels. Its synthesis involves cross-linking of monomers by 2 amino acids, desmosine and isodesmosine (D&I). Being extremely stable, elastin undergoes little metabolic turnover in healthy individuals resulting in very low levels of D&I amino acids in the human plasma, urine, or sputum. We hypothesized that in PAH patients, the elastin turnover is high; which in turn should result in elevated levels of D&I in plasma and urine. Using mass spectrometry, plasma and urine levels of D&I were measured in 20 consecutive patients with PAH confirmed by cardiac catheterization. The levels were compared with 13 healthy controls. The mean level of total plasma D&I in patients with PAH was 0.47 ng/mL and in controls was 0.19 ng/mL (P = 0.001). The mean levels of total D&I in the urine of PAH patients was 20.55 mg/g creatinine and in controls was 12.78 mg/g creatinine (P = 0.005). The mean level of free D&I in the urine of PAH patients was 10.34 mg/g creatinine and in controls was 2.52 mg/g creatinine (P < 0.001). This is the first study highlighting that the serum and urine D&I has a potential to be a novel screening biomarker for patients with PAH. It paves the way for larger studies to analyze its role in assessing for disease severity and response to treatment.

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Source
http://dx.doi.org/10.1097/MJT.0000000000000260DOI Listing

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