Kumric Marko, Borovac Josip A, Martinovic Dinko, Ticinovic Kurir Tina, Bozic Josko
Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia.
Clinic for Cardiovascular Diseases, University Hospital of Split, 21000 Split, Croatia.
Biomolecules. 2021 Jun 14;11(6):881. doi: 10.3390/biom11060881.
Despite significant strides to mitigate the complications of acute coronary syndrome (ACS), this clinical entity still represents a major global health burden. It has so far been well-established that most of the plaques leading to ACS are not a result of gradual narrowing of the vessel lumen, but rather a result of sudden disruption of vulnerable atherosclerotic plaques. As most of the developed imaging modalities for vulnerable plaque detection are invasive, multiple biomarkers were proposed to identify their presence. Owing to the pivotal role of lipids and inflammation in the pathophysiology of atherosclerosis, most of the biomarkers originated from one of those processes, whereas recent advancements in molecular sciences shed light on the use of microRNAs. Yet, at present there are no clinically implemented biomarkers or any other method for that matter that could non-invasively, yet reliably, diagnose the vulnerable plaque. Hence, in this review we summarized the available knowledge regarding the pathophysiology of plaque instability, the current evidence on potential biomarkers associated with plaque destabilization and finally, we discussed if search for biomarkers could one day bring us to non-invasive, cost-effective, yet valid way of diagnosing the vulnerable, rupture-prone coronary artery plaques.
尽管在减轻急性冠状动脉综合征（ACS）并发症方面取得了重大进展，但这一临床实体仍然是全球主要的健康负担。迄今为止，已经明确的是，导致ACS的大多数斑块并非血管腔逐渐狭窄的结果，而是易损动脉粥样硬化斑块突然破裂的结果。由于大多数用于检测易损斑块的先进成像方式具有侵入性，因此人们提出了多种生物标志物来识别它们的存在。由于脂质和炎症在动脉粥样硬化病理生理学中的关键作用，大多数生物标志物都源自这些过程之一，而分子科学的最新进展为 microRNA 的应用带来了曙光。然而，目前尚无临床应用的生物标志物或任何其他方法能够以非侵入性且可靠的方式诊断易损斑块。因此，在本综述中，我们总结了有关斑块不稳定病理生理学的现有知识、与斑块不稳定相关的潜在生物标志物的当前证据，最后，我们讨论了寻找生物标志物是否有朝一日能为我们带来一种非侵入性、经济高效且有效的诊断易损、易破裂冠状动脉斑块的方法。
