Deardorff Rachael, Spinale Francis G
Biomark Med. 2009 Oct 1;3(5):513-523. doi: 10.2217/bmm.09.60.
Heart failure (HF) is accompanied by the upregulation of bioactive signaling molecules, known as cytokines, and a family of downstream proteases, matrix metalloproteinases (MMPs). It is now apparent that these molecules contribute to adverse myocardial remodeling during HF. Elevated levels of cytokines and MMPs exist in the myocardium and can subsequently spill over into the systemic circulation. The purpose of this article is to examine clinical studies of HF that have quantified levels of different types of cytokines, MMPs and endogenous tissue inhibitors of MMPs in relation to this disease process. HF is a complex syndrome that can develop from various etiologies and can be characterized into two distinct phenotypes: systolic and diastolic. This article will present recent clinical studies that have identified significant differences between the cytokine and MMP circulating profile of systolic and diastolic HF patients. In general, elevated levels of cytokines and MMPs exist in systolic HF patients when compared with diastolic HF patients, whereas diastolic HF patients have elevated levels of cytokines and MMPs when compared with controls. Therefore, future studies distinguishing between HF phenotypes may provide more consistent results in determining possible analytes to be used as biomarkers. Furthermore, this article will emphasize why standardization of analytical techniques and establishment of referent cytokine and MMP levels are necessary if these analytes are to be used as biomarkers for the diagnosis, prognosis and evaluation of treatment in the context of HF.
心力衰竭（HF）伴随着生物活性信号分子（即细胞因子）以及下游蛋白酶家族——基质金属蛋白酶（MMPs）的上调。现在很明显，这些分子在HF期间促成了不良的心肌重塑。心肌中存在升高水平的细胞因子和MMPs，随后它们会溢出到体循环中。本文的目的是研究HF的临床研究，这些研究已经量化了不同类型的细胞因子、MMPs和MMPs的内源性组织抑制剂与该疾病过程相关的水平。HF是一种复杂的综合征，可由多种病因引起，可分为两种不同的表型：收缩性和舒张性。本文将介绍最近的临床研究，这些研究已经确定了收缩性和舒张性HF患者的细胞因子和MMP循环谱之间的显著差异。一般来说，与舒张性HF患者相比，收缩性HF患者中细胞因子和MMPs水平升高，而与对照组相比，舒张性HF患者中细胞因子和MMPs水平升高。因此，未来区分HF表型的研究可能会在确定可能用作生物标志物的分析物方面提供更一致的结果。此外，如果这些分析物要用作HF诊断、预后和治疗评估的生物标志物，本文将强调为什么分析技术的标准化以及参考细胞因子和MMP水平的建立是必要的。
