Kramer Frank, Sandner Peter, Klein Martina, Krahn Thomas
Institute for Target Discovery-Biomarker, Bayer HealthCare AG, Wuppertal, Germany.
Biomarkers. 2008 May;13(3):270-81. doi: 10.1080/13547500801903123.
The matrix metalloproteinases (MMPs) and their endogenous inhibitors, the tissue inhibitors of metalloproteinases (TIMPs) play a key role in extracellular matrix maintenance and are altered in the failing heart, both in experimental models and in chronic end-stage heart failure in humans. As the common diagnostic markers of heart failure, atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP) primarily reflect increased pressure loading, determination of soluble, heart-derived MMPs and TIMPs in plasma, as well as the determination of the emerging fibrosis marker osteopontin (OPN) might be valuable tools for detecting heart fibrosis. In this study the effect of spironolactone treatment on plasma MMP-2, TIMP-1 and OPN levels was assessed in a heart failure animal model. Unilaterally nephrectomized Sprague Dawley rats received subcutaneous injection of 100 mg deoxycorticosterone acetate (DOCA) once a week and 1% (w/v) NaCl in drinking water. Blood pressure was monitored weekly and blood samples were collected after 1, 2 and 4 weeks. After 6 weeks, left ventricular contractility (LVC) and heart weight-to-body weight ratio (HW/BW) were assessed. DOCA treatment increased plasma MMP-2, TIMP-1 and OPN concentrations. Alterations of plasma marker levels were correlated with changes of HW/BW and paralleled impaired LVC. Furthermore, beneficial effects of spironolactone treatment were observed. In DOCA-salt hypertensive rats, plasma concentrations of MMP-2, TIMP-1 and OPN reflected heart failure associated with haemodynamic, functional and morphological changes. Based on these findings, it appears reasonable to use plasma markers of fibrosis to monitor the development of heart failure.
基质金属蛋白酶(MMPs)及其内源性抑制剂金属蛋白酶组织抑制剂(TIMPs)在细胞外基质维持中起关键作用,在实验模型和人类慢性终末期心力衰竭中,衰竭心脏中的这些成分都会发生改变。作为心力衰竭的常见诊断标志物,心房利钠肽(ANP)和B型利钠肽(BNP)主要反映压力负荷增加,测定血浆中可溶性的、源自心脏的MMPs和TIMPs,以及新兴的纤维化标志物骨桥蛋白(OPN),可能是检测心脏纤维化的有价值工具。在本研究中,在心力衰竭动物模型中评估了螺内酯治疗对血浆MMP-2、TIMP-1和OPN水平的影响。单侧肾切除的Sprague Dawley大鼠每周皮下注射100 mg醋酸脱氧皮质酮(DOCA),并饮用含1%(w/v)NaCl的水。每周监测血压,并在第1、2和4周采集血样。6周后,评估左心室收缩力(LVC)和心脏重量与体重比(HW/BW)。DOCA治疗增加了血浆MMP-2、TIMP-1和OPN浓度。血浆标志物水平的改变与HW/BW的变化相关,并与LVC受损平行。此外,观察到螺内酯治疗具有有益效果。在DOCA-盐高血压大鼠中,MMP-2、TIMP-1和OPN的血浆浓度反映了与血流动力学、功能和形态学变化相关的心力衰竭。基于这些发现,使用纤维化的血浆标志物来监测心力衰竭的发展似乎是合理的。