Int J Cardiol. 2011 Jan 7;146(1):e20-2. doi: 10.1016/j.ijcard.2008.12.174. Epub 2009 Jan 30.
Prostate-specific antigen (PSA) is an established marker for the detection of prostate cancer. Both elevated and diminished PSA have been reported during acute myocardial infarction. It seems that when elevation of PSA occurs during acute myocardial infarction (AMI), coronary lesions are frequent and often more severe than when a diminution of PSA occurs. PSA has been identified as a member of the human kallikrein family of serine proteases. In recent years, numerous observations have suggested that the activity of the kallikrein-kinin system is related to inflammation and to cardiovascular diseases. PSA kallikrein, however, does not seem to have kinin-generating activity. The inactive precursor form of PSA, proPSA, is converted rapidly to active PSA by Human kallikrein 2 (hK2), suggesting an important in vivo regulatory function byhK2 on PSA activity. However, it has been reported that hK2 might not alone be able to activate proPSA in vivo, but there are also other protease/proteases involved in this event. Moreover, it seems that when elevation of prostate-specific antigen occurs during AMI, it seems to relate to a higher occurrence of major adverse cardiac events in the first 8 days after AMI than when a diminution of PSA occurs. It confirms a possible new intriguing scenario of the role of the PSA in AMI. Although these preliminary observations are suggestive, large studies need to be done to confirm these preliminary results.
前列腺特异性抗原(PSA)是检测前列腺癌的一种既定标志物。在急性心肌梗死(AMI)期间,既报道了 PSA 的升高,也报道了 PSA 的降低。似乎当 PSA 在急性心肌梗死(AMI)期间升高时,冠状动脉病变更为频繁且通常更为严重,而当 PSA 降低时则不然。PSA 已被确定为丝氨酸蛋白酶人类激肽释放酶家族的一员。近年来,大量观察结果表明,激肽释放酶-激肽系统的活性与炎症和心血管疾病有关。然而,PSA 激肽似乎没有产生激肽的活性。PSA 的无活性前体形式,前 PSA,被人激肽 2(hK2)迅速转化为有活性的 PSA,这表明 hK2 对 PSA 活性具有重要的体内调节功能。然而,据报道,hK2 可能无法单独在体内激活前 PSA,但也有其他蛋白酶/蛋白酶参与了这一事件。此外,似乎当 PSA 在 AMI 期间升高时,与 AMI 后 8 天内发生重大不良心脏事件的发生率较高有关,而当 PSA 降低时则不然。这证实了 PSA 在 AMI 中的作用的一个可能的新有趣场景。尽管这些初步观察结果具有提示性,但仍需要进行大规模研究来证实这些初步结果。