Rubiś Pawel Piotr, Dziewięcka Ewa, González Arantxa, Cleland John G F
Krakow Specialist Hospital named after St. John Paul II, Department of Cardiac and Vascular Diseases, Jagiellonian University Medical College, Krakow, Poland.
Program of Cardiovascular Disease, CIMA Universidad de Navarra, Department of Pathology, Anatomy and Physiology, Universidad de Navarra and IdiSNA, Pamplona, Spain.
Eur J Heart Fail. 2025 May;27(5):901-904. doi: 10.1002/ejhf.3375. Epub 2024 Jul 9.
Fibrosis is a common feature of many chronic diseases, including heart failure, which can have deleterious effects on cardiac structure and function that are associated with adverse outcomes. By-products of collagen synthesis and degradation, such as carboxy- and amino-terminal pro- or telo-peptides of collagen type I and III (PICP, PINP, PIIINP, and CITP) have been extensively investigated as markers of fibrosis. Although the majority of studies report on the reproducibility of their assay results, there is no a comparison of biomarker assays across studies. Therefore, we conducted a systematic review adhering to PRISMA guidelines.
The search terms employed in Medline were: 'collagen AND cardiac' or 'collagen AND heart'. This query yielded a total of 1049 articles. Thereafter, specific search criteria were applied: (i) original English-language papers; (ii) human studies; (iii) in-vivo investigations; and (iv) blood/serum/plasma samples. Overall, 89 studies were identified (42 on PIIINP, 32 on PICP, 29 on CITP, and 17 on PINP). The range of reported values for PIIINP was between 0.06 to 11 800 μg/l; for PICP 0.006 to 1265 μg/l; for CITP 0.3 to 5450 μg/l; for PINP 0.15 to 80 μg/l. Extreme variations in values for fibrosis biomarkers were observed across studies, especially when different assays were used, but also with the same assays.
Our findings show that it is challenging to ascertain normal ranges or compare studies for the measurement of fibrosis biomarkers. Given the potential implications for clinical practice and current lack of awareness of these issues, this subject warrants comprehensive acknowledgement and understanding.
纤维化是许多慢性疾病的常见特征，包括心力衰竭，它会对心脏结构和功能产生有害影响，并与不良预后相关。I型和III型胶原的羧基和氨基末端前肽或端肽（PICP、PINP、PIIINP和CITP）等胶原合成和降解的副产物已被广泛研究作为纤维化的标志物。尽管大多数研究报告了其检测结果的可重复性，但各研究之间没有对生物标志物检测进行比较。因此，我们遵循PRISMA指南进行了一项系统评价。
在Medline中使用的检索词为：“胶原与心脏”或“胶原与心脏”。该查询共产生1049篇文章。此后，应用了特定的检索标准：（i）英文原创论文；（ii）人体研究；（iii）体内研究；（iv）血液/血清/血浆样本。总体而言，确定了89项研究（42项关于PIIINP，32项关于PICP，29项关于CITP，17项关于PINP）。报告的PIIINP值范围为0.06至11800μg/l；PICP为0.006至1265μg/l；CITP为0.3至5450μg/l；PINP为0.15至80μg/l。在各项研究中观察到纤维化生物标志物值的极端差异，特别是当使用不同检测方法时，但使用相同检测方法时也存在差异。
我们的研究结果表明，确定纤维化生物标志物测量的正常范围或比较研究具有挑战性。鉴于对临床实践的潜在影响以及目前对这些问题的认识不足，该主题值得全面认识和理解。
