Renalase -一种新的多组分心力衰竭评估仪器

A. M. Alieva, M. A. Batov, K. Voronkova, O. Ettinger, R. Valiev, I. Nikitin
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摘要

尽管制定和实施了无症状患者心力衰竭早期检测和治疗计划,但由于心力衰竭并发症的发病率和死亡率不断上升,心力衰竭(HF)仍然是俄罗斯和世界卫生保健中的一个严重问题。目前,已经研究了大量新的生物标志物,这些标志物可以作为诊断和预测心力衰竭过程的实验室工具,但只有脑钠肽在实际临床实践中得到了应用。Renalase是最近发现的一种细胞因子,由肾脏合成并释放到血液中。到目前为止,已经发现了七种renalase亚型,每种亚型在人体中都发挥着不同的生理作用。Renalase通常被定位为激活细胞保护性细胞内信号的信号分子,从而降低血压并保护心肌。在成年人血液中自由循环的renalase浓度约为3-5 ng/ml。目前,renalase水平通过酶免疫测定法测定,检测范围为3.12至200 ng/ml,而标记物的最低检测浓度低于1.38 ng/ml。renalase错义多态性的存在与心肌功能障碍有关。动物和人类研究的数据表明,renalase在儿茶酚胺的代谢和心脏保护过程中起着关键作用。研究表明,renalase对心血管疾病的发生有贡献:缺血性心脏病、动脉高血压、糖尿病和主动脉狭窄。此外,多中心前瞻性研究的详细方案表明,在主动脉狭窄、高血压、代谢综合征、不稳定型心绞痛和稳定型冠状动脉疾病患者以及接受肾脏替代治疗的患者中,renalase基因的功能多态性与心肌肥大相关。基于这些数据和进一步的研究,renalase被认为是冠状动脉微血管功能障碍患者缺血的预测生物标志物,也是心血管疾病患者慢性肾脏疾病临床显著进展的预测指标。我们的综述提供了关于renalase在心力衰竭中的作用的数据。对renalase的结构和功能的进一步研究,以及未来的临床研究,将有助于确定这种生物标志物在HF和其他心血管疾病中的诊断、预后,以及可能的治疗意义。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Renalase – a new instrument in multicomponent heart failure assessment
Heart failure (HF) remains a serious problem in Russian and world health care due to the growing morbidity and mortality from complications of heart failure, despite the development and implementation of programs for the early detection and treatment of heart failure in asymptomatic patients. Currently, a large number of new biological markers have been studied that could serve as a laboratory tool for diagnosing and predicting the course of heart failure, but only brain natriuretic peptides have found application in real clinical practice. Renalase is a recently discovered cytokine that is synthesized by the kidneys and released into the blood. To date, seven subtypes of renalase have been found, each of which plays a different physiological role in the human body. Renalase is usually positioned as a signaling molecule that activates cytoprotective intracellular signals, leading to a decrease in blood pressure and protection of the heart muscle. The concentration of renalase freely circulating in the bloodstream of an adult is approximately 3–5 ng / ml. Currently, the level of renalase is determined by the enzyme immunoassay with a detection range of 3.12 to 200 ng / ml, while the minimum detectable concentration of the marker is less than 1.38 ng / ml. The presence of missense polymorphism of renalase is associated with myocardial dysfunction. Data from animal and human studies have shown that renalase plays a key role in the metabolism of catecholamines and in cardioprotective processes. Studies have shown the contribution of renalase to the occurrence of cardiovascular diseases: ischemic heart disease, arterial hypertension, diabetes mellitus, and aortic stenosis. Moreover, detailed protocols of multicenter prospective studies have demonstrated that functional polymorphism of the renalase gene was associated with myocardial hypertrophy in patients with aortic stenosis, hypertension, metabolic syndrome, unstable angina pectoris and stable forms of coronary artery disease, as well as in patients receiving renal replacement therapy. Based on these data and further studies, renalase has been proposed as a predictive biomarker of ischemia in patients with coronary microvascular dysfunction, as well as a predictor of clinically significant progression of chronic kidney disease in patients with cardiovascular diseases.Our review presents data on the role of renalase in heart failure. Further study of the structure and function of renalase, as well as future clinical studies, will allow determining the diagnostic, prognostic and, possibly, therapeutic significance of this biological marker in HF and other cardiovascular diseases.
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