Biomarkers in cardiovascular surgery biomarkers as early predictors for organ damage after cardiac surgery

Yıl 2015, Cilt: 5 Sayı: 1, 65 - 74, 03.05.2015

Tijen Alkan Bozkaya

Öz

A biomarker is a measureable substance produced by the body and used to diagnose or determine the biologic state. Most biomarkers used in the clinical medicine are the genes, proteins or other chemical substances that are expressed in the pathology or organ damage, allowing for early and fast diagnosis and treatment. Ideally, biomarkers must be generally highly sensitive in order to make an early diagnosis; provide certain cut-off values to enable risk assessment, therapeutic guidance and have prognostic value. Cardiopulmonary bypass (CPB) is a model of extracorporeal circulation consisting primarily of a pump, a reservoir and an oxygenerator. At the initiation of CPB, blood is drained from the patient into the extracorporeal circuit which has non-endothelial surface. The inflammatory process occurs after cardiac surgery in varied degrees depending on the genotypes and peroperative parameters or complexity of the cardiac pathology. This process is mediated by cellular, noncellular or humoral components of the blood. Today, safe clinical biomarkers are detected by gene technology and proteomics techniques. Using these innovative technologies, the discovery, validation and clinical use of several biomarkers have revolutionized the diagnosis and management in the field of cardiovascular surgery as well as other major medical disciplines.

Anahtar Kelimeler

Biomarkers, cardiopulmonary bypass, organ damage, genomics, proteomics

Kalp cerrahisi sonrasında organ hasarının erken belirteçleri olarak biyo-belirteçler

Öz

“Biyo-belirteç” vücut tarafından üretilen, ölçülebilir ve biyolojik durumun teşhis ve ayrımını yansıtan kimyasal maddelerdir. Klinik tıpta kullanılan birçok “biyo-belirteç” gen, protein ve diğer kimyasal maddeler olup patoloji ve organ hasarını erken, hızlı tanı ve tedavi için yönlendirmektedir. Hiçbir biyo-belirteç ideal olmamakla birlikte genel özellikleri bakımından yüksek duyarlı olmalı, erken teşhis yaptırabilmeli, belli bir kesim noktasına göre ilgili olguda risk değerlendirmesi yapılabilmesini sağlamalı, ayrıca tedaviye yanıtı yönlendirebilmeli ve ilgili hasar veya hastalık durumu için prognostik olmalıdır. İlgili yanıt ya da karakteristiği istatistiksel olarak güçlü olmalıdır. Ek olarak biyobelirteçler patoloji için özgün olmalı, diğer nedenlerden ayırt ettirebilmeli, hastalığın şiddeti ve klinik sonuçlar ile paralel olmalıdır. Kardiyopulmoner bypas (KPB), bir ekstrakorporeal dolaşım modeli olup esas olarak bir pompa, rezervuar ve oksijeneratörden oluşur. KPB’ın başlangıcında kan hastadan bu endotelyal yüzey içermeyen ekstrakorporeal dolaşıma katılarak hastanın genotipi, peroperatif parametreler ve patolojinin kompleksitesine göre kalp cerrahisi sonrasında değişik derecelerde gelişen ve kanın hücresel, hücre dışı veya humoral bileşenleri tarafından yönetilen inflamatuvar süreci başlatır. Günümüzde güvenli klinik biyo-belirteçler gen teknolojileri ve proteomiks teknikleri ile tespit edilmektedir. Bu yenilikçi tekniklerin kullanımı ile birçok değişik biyobelirteçler keşfedilip klinik uygulamaya girmiş ve diğer majör tıp dallarında olduğu gibi kalp cerrahisi alanında da çığır açmıştır.

Anahtar Kelimeler

Biyo-belirteçler, kardiyopulmoner bypas, organ hasarı, genomiks, proteomiks

Kaynakça

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