Carlson Eric J, Rushkin Megan, Darby Derek, Chau Trisha, Shirley Renee L, King Jeff S, Nguyen Khanh, Landry Gregory J, Moneta Gregory L, Abraham Cherrie, Sakai Lynn Y, Azarbal Amir F
Department of Molecular and Medical Genetics, Oregon Health & Science University, Portland, OR.
Department of Orthopedics, Oregon Health & Science University, Portland, OR.
JVS Vasc Sci. 2022 Oct 13;3:389-402. doi: 10.1016/j.jvssci.2022.09.001. eCollection 2022.
Fragments of fibrillin-1 and fibrillin-2 will be detectable in the plasma of patients with aortic dissections and aneurysms. We sought to determine whether the plasma fibrillin fragment levels (PFFLs) differ between patients with thoracic aortic pathology and those presenting with nonaortic chest pain.
PFFLs were measured in patients with thoracic aortic aneurysm (n = 27) or dissection (n = 28). For comparison, patients without aortic pathology who had presented to the emergency department with acute chest pain (n = 281) were categorized into three groups according to the cause of the chest pain: ischemic cardiac chest pain; nonischemic cardiac chest pain; and noncardiac chest pain. The PFFLs were measured using a sandwich enzyme-linked immunosorbent assay.
Fibrillin-1 fragments were detectable in all patients and were lowest in the ischemic cardiac chest pain group. Age, sex, and the presence of hypertension were associated with differences in fibrillin-1 fragment levels. Fibrillin-2 fragments were detected more often in the thoracic aneurysm and dissection groups than in the emergency department chest pain group ( < .0001). Patients with aortic dissection demonstrated a trend toward increased detectability ( = .051) and concentrations ( = .06) of fibrillin-2 fragments compared with patients with aortic aneurysms. Analysis of specific antibody pairs identified fibrillin-1 B15-HRP26 and fibrillin-2 B205-HRP143 as the most informative in distinguishing between the emergency department and aortic pathology groups.
Patients with thoracic aortic dissections demonstrated elevated plasma fibrillin-2 fragment levels (B205-HRP143) compared with patients presenting with ischemic or nonischemic cardiac chest pain and increased fibrillin-1 levels (B15-HRP26) compared with patients with ischemic cardiac chest pain. Investigation of fibrillin-1 and fibrillin-2 fragment generation might lead to diagnostic, therapeutic, and prognostic advances for patients with thoracic aortic dissection.
在主动脉夹层和动脉瘤患者的血浆中可检测到原纤维蛋白-1和原纤维蛋白-2片段。我们试图确定胸主动脉病变患者与非主动脉性胸痛患者的血浆原纤维蛋白片段水平（PFFLs）是否存在差异。
测量胸主动脉瘤患者（n = 27）或夹层患者（n = 28）的PFFLs。为作比较，因急性胸痛就诊于急诊科且无主动脉病变的患者（n = 281）根据胸痛原因分为三组：缺血性心脏性胸痛；非缺血性心脏性胸痛；非心脏性胸痛。使用夹心酶联免疫吸附测定法测量PFFLs。
在所有患者中均可检测到原纤维蛋白-1片段，且在缺血性心脏性胸痛组中最低。年龄、性别和高血压的存在与原纤维蛋白-1片段水平的差异相关。与急诊科胸痛组相比，在胸主动脉瘤和夹层组中原纤维蛋白-2片段的检测更为常见（P <.0001）。与主动脉瘤患者相比，主动脉夹层患者的原纤维蛋白-2片段可检测性（P =.051）和浓度（P =.06）有增加趋势。对特定抗体对的分析确定原纤维蛋白-1 B15-HRP26和原纤维蛋白-2 B205-HRP143在区分急诊科和主动脉病变组方面最具信息量。
与缺血性或非缺血性心脏性胸痛患者相比，胸主动脉夹层患者的血浆原纤维蛋白-2片段水平（B205-HRP143）升高，与缺血性心脏性胸痛患者相比，原纤维蛋白-1水平（B15-HRP26）升高。对原纤维蛋白-1和原纤维蛋白-2片段生成的研究可能会为胸主动脉夹层患者带来诊断、治疗和预后方面的进展。
