Potential clinical utility of macrophage colony-stimulating factor, monocyte chemotactic protein-1 and myeloperoxidase in predicting atherosclerotic plaque instability.

Coronary artery diseases (CAD) are the most common cause of morbidity and mortality despite significant advances in their treatment. Therefore, current research focuses on identifying at-risk individuals with vulnerable atherosclerotic plaques in coronary arteries prior to its rupture. This requires to determine specific biomarkers that can not only detect active vulnerable plaque, but also monitor the risk of its progression and rupture. Various biomolecules, from the foam cell formation to plaque rupture, are released into the blood plasma and may serve as biomarkers of atherogenesis. This review provides an up-to-date overview of some biomolecules released from activated macrophages with a focus on their potential utility for clinical practice. It is important that these biomarkers can distinguish patients with stable, inactive plaques from those with unstable, active plaques, and also predict an increased risk of acute coronary events. Special attention was focused on the selected myeloid markers of atherosclerosis and plaque instability, including macrophage colony-stimulating factor (M-CSF), monocyte chemotactic protein-1 (MCP-1), and myeloperoxidase (MPO), which are released from activated leukocytes into blood plasma. Changed plasma levels of these biomarkers can indicate an acute phase of plaque destabilization. This makes it possible not only to measure their plasma concentrations using available biochemical laboratory methods, but also to apply them in clinical practice. In addition, the discussed biomarkers could be a potential therapeutic target leading to a reduction in premature morbidity and mortality of CAD.