A long pentraxin, PTX3, is produced by vascular cells or inflammatory cells and released into the circulation, possibly reflecting local inflammation in the cardiovascular system.
This study was designed to assess the clinical significance of plasma pentraxin 3 (PTX3) levels in chronic heart failure (CHF).
We measured plasma PTX3 levels in 37 patients with non-ischemic CHF (dilated cardiomyopathy) using enzyme-linked immunosorbent assay (ELISA) methods.
The plasma PTX3 levels were higher in CHF patients than in healthy subjects (P=0.001), and the CHF patients in the highest tertile of plasma PTX3 levels had more cardiac events than the patients in the lowest tertile (42% vs. 0%, P=0.02). Multivariate regression analysis showed that PTX3 was the most significant predictor of cardiac events (hazard ratio 1.912 for each increase in PTX3 of 1 ng/ml, P=0.019, 95% CI 1.114-3.282). In addition, PTX3 was strikingly expressed in human myocardial cells obtained from a biopsy specimen in a patient.
Plasma PTX3 levels might be a potentially useful biomarker to predict prognosis as well as to detect inflammatory status in patients with CHF.
"In contrast, high PTX3 concentrations were related to heart failure, contributing to cardiac commitment definition and associated with severity of dilative cardiomyopathy. Besides, increased PTX3 levels were observed in cardiac acute processes such as myocardial infarction and unstable angina . Thus, these findings reflect different features of PTX3 in inflammatory process and suggest its use to assess clinical progression in cardiac disease. "
"PTX3 levels were positively associated with the severity of dilatative cardiomyopathy and increased risk of HF . Furthermore high PTX3 plasma levels (but not CRP, interleukin-6, or TNF-α) were associated with an echocardiographic measure of left ventricular dysfunction (E/e′ ratio) in controls without HF and in patients with HF and normal or reduced ejection fraction . "
[Show abstract][Hide abstract] ABSTRACT: Pentraxin 3 (PTX3) is an essential component of the humoral arm of innate immunity and belongs, together with the C-reactive protein (CRP) and other acute phase proteins, to the pentraxins' superfamily: soluble, multifunctional, pattern recognition proteins. Pentraxins share a common C-terminal pentraxin domain, which in the case of PTX3 is coupled to an unrelated long N-terminal domain. PTX3 in humans, like CRP, correlates with surrogate markers of atherosclerosis and is independently associated with the risk of developing vascular events. Studies addressing the potential physiopathological role of CRP in the cardiovascular system were so far inconclusive and have been limited by the fact that the sequence and regulation have not been conserved during evolution between mouse and man. On the contrary, the conservation of sequence, gene organization, and regulation of PTX3 supports the translation of animal model findings in humans. While PTX3 deficiency is associated with increased inflammation, cardiac damage, and atherosclerosis, the overexpression limits carotid restenosis after angioplasty. These observations point to a cardiovascular protective effect of PTX3 potentially associated with the ability of tuning inflammation and favor the hypothesis that the increased levels of PTX3 in subjects with cardiovascular diseases may reflect a protective physiological mechanism, which correlates with the immunoinflammatory response observed in several cardiovascular disorders.
Mediators of Inflammation 04/2013; 2013(5):725102. DOI:10.1155/2013/725102 · 3.24 Impact Factor
"In their study, prognostic value of PTX3 was superior to that provided by CRP, CK, TnT, and NT-proBNP . Additional studies introduced PTX3 as a prognostic biomarker in heart failure, both acute and chronic, which was unrelated to an AMI [26, 27]. In the cardiovascular health study, PTX3 has been established to associate with the incidence of CAD and all-cause mortality in CAD patients, independently of CRP and other classical risk factors . "
[Show abstract][Hide abstract] ABSTRACT: Inflammatory or anti-inflammatory? That is the question as far as the acute-phase response and its mediators, the pentraxins, are concerned. Only some ten years ago, the classical or short pentraxin C-reactive protein and the newly discovered long pentraxin PTX3 were considered to exert most of the detrimental effects of acute inflammation, whether microbial or sterile in origin. However, accumulating evidence suggests an at least dichotomous, context-dependent outcome attributable to the pentraxins, if not a straightforward anti-inflammatory nature of the acute-phase response. This paper is focused on the inherent effects of pentraxin 3 in inflammatory responses, mainly in coronary artery disease and in Aspergillus fumigatus infection. Both are examples of inflammatory reactions in which PTX3 is substantially involved; the former sterile, the latter infectious in origin. Apart from different inducing noxae, similarities in the pathogenesis of the two are striking. All the same, the introductory question still persists: is the ultimate impact of PTX3 in these conditions inflammatory or anti-inflammatory, paradoxical as the latter might appear? We try to provide an answer such as it emerges in the light of recent findings.
Mediators of Inflammation 04/2012; 2012(5):920517. DOI:10.1155/2012/920517 · 3.24 Impact Factor
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