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Evaluation of Neopterin Levels and Kynurenine Pathway in Acute Coronary Syndrome Patients

Year 2023, Volume: 43 Issue: 4, 340 - 351, 01.12.2023
https://doi.org/10.52794/hujpharm.1261037

Abstract

The leading cause of coronary artery disease is coronary atherosclerosis. Intracoronary thrombus caused by rupture of atherosclerotic plaque is the main cause of acute coronary syndrome. It has been shown in various studies that tear-sensitive plaques contain more macrophages and T lymphocytes. Neopterin is an important biomarker of cellular immune response. It is considered an important biomarker of early diagnosis and prognosis in a wide variety of pathologies, including inflammation, infections and malignancies. In addition to the release of neopterin in cellular immune activation, indolamine 2,3-dioxygenase (IDO), which catalyzes the rate limiting step in tryptophan degradation, is also induced. It has been reported that the IDO activity, shown by kynurenine (Kyn) to tryptophan (Trp) ratio, can be used as an important indicator in the regulation of cellular immunity, supported by immune variables. In this review, it is aimed to evaluate the possible changes in the diagnosis of coronary artery disease (CAD), mortality and morbidity determination of biochemical indicators such as neopterin, C-reactive protein (CRP), IDO in patients with acute coronary syndrome that develop angiographically on the basis of atherosclerosis. Determination and use of neopterin levels and kynurenine pathway parameters as biomarkers in acute coronary syndrome patients are meaningful and valuable.

References

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Neopterin Düzeylerinin ve Kinürenin Yolağının Akut Koroner Sendrom Hastalarında Değerlendirilmesi

Year 2023, Volume: 43 Issue: 4, 340 - 351, 01.12.2023
https://doi.org/10.52794/hujpharm.1261037

Abstract

Neopterin Düzeylerinin ve Kinürenin Yolağının Akut Koroner Sendrom Hastalarında Değerlendirilmesi
Koroner arter hastalığının en önemli nedeni koroner aterosklerozdur. Aterosklerotik plağın yırtılması ile oluşan intrakoroner trombüs ise akut koroner sendomun temel nedenidir. Yırtılmaya hassas plakların daha fazla sayıda maktofaj ve T lenfosit içerdiği çeşitli çalışmalarda gösterilmiştir. Neopterin hücresel immün yanıtın önemli bir biyogöstergesidir. İnflamasyon, çeşitli enfeksiyonlar ve maligniteler de dahil olmak üzere çok çeşitli patolojilerde erken tanı ve prognoz için önemli bir biyomarkör olarak kabul edilir. Hücresel immün aktivasyonda neopterin salınımına ilave olarak triptofan yıkımında hız kısıtlayıcı basamağı katalizleyen indolamin 2,3-dioksijenaz (İDO) enzimi de aynı anda indüklenir. Kinürenin (Kyn) in triptofan (Trp) ’a oranlanmasıyla ifade edilebilien İDO aktivitesinin, immün değişkenlerle desteklenerek hücresel immünitenin düzenlenmesinde önemli bir gösterge olarak kullanılabileceği rapor edilmiştir. Bu derleme makalesinde, anjiyografik olarak ateroskleroz zemininde gelişen akut koroner sendrom (AKS) hastalarında, neopterin, C reaktif protein (CRP), İDO gibi biyokimyasal göstergelerin koroner arter hastalığı (KAH) tanısı, mortalite ve morbidite süreçlerindeki olası değişimlerin değerlendirilmesi hedeflenmiştir. Akut koroner sendrom hastalarında, neopterin düzeyleri ile kinürenin yolağı parametlerinin belirlenmesi ve biyomarkör olarak kullanılmaları anlamlı ve değerlidir.

References

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  • 3. Polyzos KA, Ketelhuth DF. The role of the kynurenine pathway of tryptophan metabolism in cardiovascular disease. An emerging field. Hamostaseologie. 2015, 35:128–136. DOI: 10.5482/HAMO-14-10-0052
  • 4. Hoffmann G, Wirleitner B, Fuchs D. Potential role of immune system activation associated production of neopterin derivatives in humans. Inflammation Research. 2003, 52:313-321. DOI: 10.1007/s00011-003-1181-9
  • 5. Eisenhut M. Neopterin in diagnosis and monitoring of infectious diseases. Journal of Biomarkers. 2013, 2013:196432. DOI: 10.1155/2013/196432
  • 6. Soliman H, Mediavilla-Varela M, Indoleamine 2,3-dioxygenase: is it an immune suppressor? Cancer Journal. 2010, 16:354- 359. DOI: 10.1097/PPO.0b013e3181eb3343
  • 7. Schrocksnadel K, Wirleitner B, Winkler C, Fuchs D. Monitoring tryptophan metabolism in chronic immune activation. Clinica Chimica Acta. 2006, 364:82-90. DOI: 10.1016/j. cca.2005.06.013
  • 8. King NJ, Thomas SR. Molecules in focus: Indoleamine 2,3-dioxygenase. The International Journal Biochemistry and Cell Biolology. 2007, 39:2167–2172. DOI: 10.1016/j.biocel. 2007.01.004
  • 9. Curti A, Trabanelli S, Salvestrini V, Baccarani M, Lemoli RM. The role of indoleamine 2,3-dioxygenase in the induction of immune tolerance: focus on hematology. Blood. 2009, 113:2394-2401. DOI: 10.1182/blood-2008-07-144485
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  • 13. Mozaffarian D. Benjamin E. J, Go AS, Arnett DK, Blaha MJ, Cushman M, et al. Heart disease and stroke statistics- 2015 update: a report from the American Heart Association. Circulation. 2015, 131(4):e29-322. DOI: 10.1161/ CIR.0000000000000152
  • 14. Onat A (Editör). TEKHARF 2015 Yetişkinlerimizin Sağlığı ve Kronik Hastalıklara Tıbbın Yaklaşımına Öncülük. Logos Yayıncılık; İstanbul, 2015.
  • 15. Libby P. Current concepts of the pathogenesis of the acute coronary syndromes. Circulation. 2001, 104(3):365-372. DOI: 10.1161/01.cir.104.3.365
  • 16. Libby P. Inflammatory mechanisms : the moleculer basis of inflammation and disease. Nutrition Reviews. 2007, 65(12 Pt2):140-146. DOI: 10.1111/j.1753-4887.2007.tb00352.x
  • 17. Dehnavi RA, de Ross A, Rabelink TJ, van Pelt J, Wensink MJ, Romijn JA, et al. Elevated CRP levels are associated with increased carotid atherosclerosis idependent of visceral obesity. Atherosclerosis. 2008, 200(2):417-423. DOI: 10.1016/j. atherosclerosis.2007.12.050
  • 18. Rizzo M, Corrado E, Coppola G, Muratori I, Novo G, Novo S. Markers of inflammation are strong predictors of subclinical and clinical atherosclerosis in women with hypertension. Coronary Artery Disease. 2009, 20(1):15-20. DOI: 10.1097/ MCA.0b013e3283109065
  • 19. Ross R. The pathogenesis of atherosclerosis an update. The New England Journal of Medicine. 1986, 314(8):488-500. DOI: 10.1056/NEJM198602203140806
  • 20. Moreno PR, Falk E, Palacios IF, Newell JB, Fuster V, Fallon JT. Macrophage infiltration in acute coronary syndromes. Implications for plaque rupture. Circulation. 1994, 90(2):775- 778. DOI: 10.1161/01.cir.90.2.775
  • 21. Celermajer DS. Endothelial dysfunction: Does it matter? Is it reversible? Journal of the American Collage of Cardiology. 1997, 30(2):325-333. DOI: 10.1016/s0735-1097(97)00189-7
  • 22. Hillis GS, Flapan AD. Cell adhesion molecules in cardiovascular disease: a clinical perspective. Heart. 1998, 79:429-431. DOI: 10.1136/hrt.79.5.429
  • 23. Libby P. Molecular bases of the acute coronary syndromes. Circulation. 1995, 91:2844-2850. DOI: 10.1161/01.cir.91.11.2844
  • 24. Kültürsay H. Koroner kalp hastalığında yüksek risk kavramı. The Anatolian Journal of Cardiology. 2002, 2(1): 61-64. https://jag.journalagent.com/anatoljcardiol/pdfs/AnatolJCardiol_ 2_1_61_64.pdf
  • 25. Okamatsu K, Takano M, Sakai S. Ishibashi F, Uemura R, Takano T, et al. Elevated troponin T levels and lesion characteristics in non-ST-elevation acute coronary syndromes. Circulation. 2004, 109 (4): 465-470. DOI: 10.1161/01. CIR.0000109696.92474.92
  • 26. Macrae AR, Kavsak PA, Lustig V, Bhargava R, Vandersluis R, Palomaki GE, et al. Assessing the requirement for the 6-hour interval between specimens in the American Heart Association classification of myocardial infarction in epidemiology and clinical research studies. Clinical Chemistry. 2006, 52(5):812- 818. DOI: 10.1373/clinchem.2005.059550
  • 27. Weber M, Bazzino O, Navarro Estrada JL, de Miguel R, Salzberg S, Fuselli JJ, et al. Improved diagnostic and prognostic performance of a new high-sensitive troponin T assay in patients acute coronary syndrome. American Heart Journal. 2011, 162(1):81-88. DOI: 10.1016/j.ahj.2011.04.007
  • 28. Thygesen K, Alpert JS, White HD. Universal definition of myocardial infarction. European Heart Journal. 2007, 28:2525-2538. DOI: 10.1093/eurheartj/ehm355
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There are 63 citations in total.

Details

Primary Language Turkish
Subjects Pharmacology and Pharmaceutical Sciences
Journal Section Review Articles
Authors

İbrahim Kember 0000-0002-8440-4242

Gözde Girgin 0000-0002-7051-0490

Terken Baydar 0000-0002-5497-9600

Publication Date December 1, 2023
Acceptance Date June 20, 2023
Published in Issue Year 2023 Volume: 43 Issue: 4

Cite

Vancouver Kember İ, Girgin G, Baydar T. Neopterin Düzeylerinin ve Kinürenin Yolağının Akut Koroner Sendrom Hastalarında Değerlendirilmesi. HUJPHARM. 2023;43(4):340-51.