Rani Aishwarya, Singh Lakhwinder, Chakraborti Anuradha, Gupta Sameer, Singh Harkant, Toor Devinder
Amity Institute of Virology and Immunology, Amity University Uttar Pradesh, Noida, Uttar Pradesh, India.
Department of Experimental Medicine and Biotechnology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Asian Cardiovasc Thorac Ann. 2025 Jan;33(1):14-20. doi: 10.1177/02184923241306482. Epub 2024 Dec 12.
BackgroundRheumatic heart disease (RHD) remains a persistent public health challenge, particularly prevalent in developing and underdeveloped regions despite concerted global eradication efforts. The progressive stage of RHD, marked by valvular calcification, necessitates the imperative need to identify prognostic biomarkers. Fetuin-A, well-known for its role as a negative inhibitor of ectopic calcification, is investigated in our study as a potential biomarker for cardiac valve calcification in RHD patients.MethodsIndividuals with confirmed presence of RHD via echocardiography, who exhibited moderate to severe cardiac valve involvement, were enrolled alongside age and sex-matched healthy controls. Enzyme Linked Immunosorbent Assay was performed to analyse serum concentration of fetuin-A in healthy controls and RHD patients. Cytokine profiling was carried out using Cytometric Bead Array.ResultsSixty confirmed RHD patients along with age and sex-matched case-control were evaluated for their serum fetuin-A and serum cytokines levels. Our findings reveal significantly reduced serum fetuin-A levels in RHD patients (1.96 ± 0.608 ng/ml) compared to healthy controls (2.85 ± 0.55 ng/ml) ( < 0.0001). Cytokine profiling shows nearly two-fold elevations in interleukin (IL)-17A, tumor necrosis factor-alpha (TNF-α), interferon-gamma (IFN-γ), IL-6, IL-10, IL-4 and IL-2 levels among RHD patients versus healthy controls, with IL-6 showing the maximum elevation in serum concentration. Pearson's correlation coefficient () values indicate a strong negative correlation between fetuin-A levels in RHD patients and various inflammatory cytokines, including IL-17A (-0.9754), IFN-γ (-0.8142), TNF-α (-0.8281), IL-10 (-0.9183), IL-6 (-0.8479), IL-4 (-0.9182) and IL-2 (-0.9430) ( < 0.05, statistically significant).ConclusionThis study suggests that fetuin-A can be explored as a plausible biomarker for cardiac valve calcification and has an inverse correlation with inflammatory cytokines involved in RHD.
背景
风湿性心脏病（RHD）仍然是一个持续存在的公共卫生挑战，尽管全球共同努力根除，但在发展中和欠发达地区尤为普遍。RHD的进展阶段以瓣膜钙化为特征，因此迫切需要确定预后生物标志物。胎球蛋白-A因其作为异位钙化的负性抑制剂的作用而闻名，在我们的研究中被作为RHD患者心脏瓣膜钙化的潜在生物标志物进行研究。
方法
通过超声心动图确诊患有RHD且表现出中度至重度心脏瓣膜受累的个体，与年龄和性别匹配的健康对照一起纳入研究。采用酶联免疫吸附测定法分析健康对照和RHD患者血清中胎球蛋白-A的浓度。使用细胞计数珠阵列进行细胞因子谱分析。
结果
对60例确诊的RHD患者以及年龄和性别匹配的病例对照进行了血清胎球蛋白-A和血清细胞因子水平的评估。我们的研究结果显示，与健康对照（2.85±0.55 ng/ml）相比，RHD患者血清胎球蛋白-A水平显著降低（1.96±0.608 ng/ml）（<0.0001）。细胞因子谱分析显示，与健康对照相比，RHD患者中白细胞介素（IL）-17A、肿瘤坏死因子-α（TNF-α）、干扰素-γ（IFN-γ）、IL-6、IL-10、IL-4和IL-2水平升高近两倍，其中IL-6血清浓度升高幅度最大。Pearson相关系数（）值表明，RHD患者胎球蛋白-A水平与多种炎性细胞因子之间存在强负相关，包括IL-17A（-0.9754）、IFN-γ（-0.8142）、TNF-α（-0.8281）、IL-10（-0.9183）、IL-6（-0.8479）、IL-4（-0.9182）和IL-2（-0.9430）（<0.05，具有统计学意义）。
结论
本研究表明，胎球蛋白-A可作为心脏瓣膜钙化的一种可能的生物标志物进行探索，并且与RHD中涉及的炎性细胞因子呈负相关。
