Department of Human Physiology and Pathophysiology, Faculty of Medicine, Collegium Medicum Cardinal Stefan Wyszynski University in Warsaw, Wóycickiego 1/3, 01-938 Warsaw, Poland; College of Medical Sciences, Nicolaus Copernicus Superior School, Nowogrodzka 47a, 00-695 Warsaw, Poland.
First Department of Cardiology, Medical University of Warsaw, Banacha 1A, 02-097 Warsaw, Poland.
Cytokine Growth Factor Rev. 2023 Dec;74:76-85. doi: 10.1016/j.cytogfr.2023.08.009. Epub 2023 Aug 25.
Myocardial infarction with nonobstructive coronary arteries (MINOCA) remains a puzzling clinical entity. It is characterized by clinical evidence of myocardial infarction (MI) with normal or near-normal coronary arteries in angiography. Given the complex etiology including multiple possible scenarios with varied pathogenetic mechanisms, profound investigation of the plausible biomarkers of MINOCA may bring further pathophysiological insights and novel diagnostic opportunities. Cytokines have a great diagnostic potential and are used as biomarkers for many diseases. An unusual trio of visfatin, placental growth factor (PlGF) and fractalkine (CX3CL1) can directly promote vascular dysfunction, inflammation and angiogenesis through the activation of the nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) signaling. They are redundant in physiological processes and become overexpressed in the pathomechanisms underlying MINOCA. The knowledge about their concentration might serve as a valuable diagnostic and/or therapeutic tool for assessing vascular endothelial function. Here we analyze the current knowledge on visfatin, PlGF and CX3CL1 in the context of MINOCA and present the novel clinical implications of their combined expression as predictors or indicators of this condition.
非阻塞性冠状动脉心肌梗死（MINOCA）仍然是一个令人费解的临床实体。其特征是在血管造影中存在心肌梗死（MI）的临床证据，但冠状动脉正常或接近正常。鉴于包括多种可能的发病机制的复杂病因，深入研究 MINOCA 的可能生物标志物可能会带来进一步的病理生理学见解和新的诊断机会。细胞因子具有很大的诊断潜力，并且被用作许多疾病的生物标志物。不寻常的三联体内脏脂肪素、胎盘生长因子（PlGF）和 fractalkine（CX3CL1）可以通过核因子 kappa-轻链增强子的激活直接促进血管功能障碍、炎症和血管生成B 细胞（NF-κB）信号。它们在生理过程中是冗余的，在 MINOCA 发病机制中过度表达。关于它们浓度的知识可能是评估血管内皮功能的有价值的诊断和/或治疗工具。在这里，我们分析了内脏脂肪素、PlGF 和 CX3CL1 在 MINOCA 背景下的现有知识，并提出了它们联合表达作为该疾病预测因子或标志物的新的临床意义。
