Boutin Gabrielle, Yuzugulen Jale, Pranjol Md Zahidul Islam
School of Life Sciences, University of Sussex, Brighton, UK.
Faculty of Pharmacy, Eastern Mediterranean University, Famagusta, North Cyprus via Mersin 10, Turkey.
J Mol Cell Cardiol Plus. 2023 Oct 13;6:100053. doi: 10.1016/j.jmccpl.2023.100053. eCollection 2023 Dec.
Current cardiac biomarkers, troponins and brain natriuretic peptide, are primarily used to assist in the diagnosis or exclusion of myocardial damage and congestive heart failure, respectively. The use of these biomarkers in chemotherapy-induced cardiotoxicity has been evaluated by various studies. However, neither biomarker provides early predictive value, leaving many cancer survivors with irreversible cardiac injury. Assessing endothelial dysfunction could be an effective measure of chemotherapy-induced cardiotoxicity at the vascular level. Risk profiling and detection of vascular toxicities may offer predictive biomarkers to prevent chronic manifestation of irreversible cardiotoxicities. Emerging interest has developed in finding biomarkers that could ideally provide earlier prognostic value. Thus, the aim of this review is to give an overview of current blood-based cardiac biomarkers and discuss the potential of endothelin-1 (ET-1) and more stable peptide fragments of ET-1 synthesis as biomarkers of endothelial dysfunction. For instance, endothelin-like domain peptide (ELDP) and C-terminal pro-endothelin-1 (CT-proET-1) demonstrated high-sensitivity and longer clearance rate than ET-1. Thus, investigating their biomarker role in chemotherapy-induced cardiotoxicity is important and could provide additional insights for identifying patients at risk. Also, additional research is required to fully understand ELDP-mediated vasoconstriction. This review will discuss the future development of ET-1, ELDP and CT-proET-1 as prospective predictive biomarkers.
目前的心脏生物标志物，肌钙蛋白和脑钠肽，主要分别用于辅助诊断或排除心肌损伤和充血性心力衰竭。各种研究已经评估了这些生物标志物在化疗引起的心脏毒性中的应用。然而，这两种生物标志物都不能提供早期预测价值，导致许多癌症幸存者出现不可逆的心脏损伤。评估内皮功能障碍可能是在血管水平上检测化疗引起的心脏毒性的有效措施。风险评估和血管毒性检测可能会提供预测性生物标志物，以预防不可逆心脏毒性的慢性表现。人们越来越关注寻找能够理想地提供早期预后价值的生物标志物。因此，本综述的目的是概述当前基于血液的心脏生物标志物，并讨论内皮素-1（ET-1）及其更稳定的ET-1合成肽片段作为内皮功能障碍生物标志物的潜力。例如，内皮素样结构域肽（ELDP）和C末端前内皮素-1（CT-proET-1）表现出比ET-1更高的敏感性和更长的清除率。因此，研究它们在化疗引起的心脏毒性中的生物标志物作用很重要，并且可以为识别有风险的患者提供更多见解。此外，还需要更多研究来充分了解ELDP介导的血管收缩。本综述将讨论ET-1、ELDP和CT-proET-1作为前瞻性预测生物标志物的未来发展。
