Neuromuscular Unit, Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland.
Clin Chim Acta. 2011 Aug 17;412(17-18):1533-8. doi: 10.1016/j.cca.2011.04.033. Epub 2011 May 5.
Tenascin-C (TN-C), an extracellular matrix glycoprotein, is of diagnostic and prognostic value in different heart diseases. One such dilated cardiomyopathy (DCM) with conduction disturbances is one of the most serious manifestations in Emery-Dreifuss muscular dystrophy (EDMD). Herein we therefore detail work to evaluate the potential significance of circulating TN-C in patients with EDMD, speculating that it may define the cardiac dysfunction, especially in patients who may be cardiac asymptomatic, but still be at risk of sudden death.
Serum levels of TN-C were quantified by sandwich immunoassay ELISA in 25 EDMD patients (10 with laminopathy-AD-EDMD and 15 with emerinopathy-X-EDMD), 8 X-EDMD carriers, 9 disease controls (patients with dystrophinopathy), and 15 age-matched healthy controls. Fourteen of the EDMD patients had repeated TN-C examinations after 3 to 7 years.
The levels of circulating TN-C were elevated in AD-EDMD and X-EDMD patients, as well as in some X-EDMD carriers, and patients with dystrophinopathy. The correlation between the TN-C level and left end-systolic ventricle diameter (LVDD) was significant in X-EDMD, while those with left atrium diameter (LAD) and the ejection fraction (EF) were not. In "follow-up" studies TN-C levels were not found to change over time in AD-EDMD, while rising in X-EDMD.
The presented results indicate that assessments of circulating TN-C levels may help to identify EDMD patients at risk of dilated cardiomyopathy. TN-C might therefore be considered a candidate for a new biomarker, useful in detecting of cardiomyopathy and in further monitoring of the DCM therapy in patients with EDMD.
Tenascin-C(TN-C)是一种细胞外基质糖蛋白,在不同的心脏疾病中有诊断和预后价值。其中一种伴传导障碍的扩张型心肌病(DCM)是 Emery-Dreifuss 肌营养不良症(EDMD)最严重的表现之一。因此,我们在此详细评估了循环 TN-C 在 EDMD 患者中的潜在意义,推测其可能定义了心脏功能障碍,尤其是在那些可能无症状但仍有猝死风险的患者中。
采用夹心免疫酶联吸附试验(ELISA)法检测 25 例 EDMD 患者(10 例 laminopathy-AD-EDMD 和 15 例 emerinopathy-X-EDMD)、8 例 X-EDMD 携带者、9 例疾病对照(肌营养不良症患者)和 15 名年龄匹配的健康对照者的血清 TN-C 水平。其中 14 例 EDMD 患者在 3 至 7 年后重复进行了 TN-C 检查。
AD-EDMD 和 X-EDMD 患者以及部分 X-EDMD 携带者和肌营养不良症患者的循环 TN-C 水平升高。X-EDMD 患者的 TN-C 水平与左心室收缩末期直径(LVDD)呈显著相关,而与左心房直径(LAD)和射血分数(EF)无相关性。在“随访”研究中,AD-EDMD 患者的 TN-C 水平未随时间而变化,而 X-EDMD 患者的 TN-C 水平则升高。
本研究结果表明,循环 TN-C 水平的评估可能有助于识别 EDMD 患者中扩张型心肌病的风险。因此,TN-C 可作为一种新的生物标志物的候选物,用于检测心肌病,并进一步监测 EDMD 患者的 DCM 治疗效果。