Vascular Health and Risk Management (Mar 2022)
Metabolic Pathway of Cardiac Troponins and Its Diagnostic Value
Abstract
Aleksey Chaulin1,2 1Department of Cardiology and Cardiovascular Surgery, Samara State Medical University, Samara, 443099, Russia; 2Department of Histology and Embryology, Samara State Medical University, Samara, 443099, RussiaCorrespondence: Aleksey Chaulin Department of Cardiology and Cardiovascular Surgery, Samara State Medical University, 89 Chapaevskaya Street, Samara Region, Samara, 443099, Russia Tel + 7 927 770-25-87 Email [email protected]: The study of the metabolic pathway of endo- and exogenous molecules is not only of great fundamental significance, but also of high practical importance, since many molecules serve as drug targets and/or biomarkers for laboratory diagnostics of diseases. Thus, cardiac troponin molecules have long been used as main biomarkers for confirmation of diagnosis of acute myocardial infarction (AMI), and with the introduction of modern (high-sensitivity) test methods many of our ideas about biology and metabolism of these cardiac markers have changed significantly. In clinical practice, there are opening new promising diagnostic capabilities of cardiac troponins, the understanding and justification of which is closely connected with the fundamental principles of the metabolism of these molecules. However, today the metabolic pathway of cardiac troponins has not been properly investigated, in particular, we do not know precise mechanisms of release of these molecules from the myocardium of healthy people and the mechanisms of circulation and elimination of cardiac troponins from the blood stream. Meanwhile, these stages of the metabolic pathway of cardiac troponins may exercise a dominant influence on serum levels of cardiac troponins, and this may be particularly significant when using rapid diagnostic algorithms for AMI. Refinement of some aspects of the metabolism of cardiac troponins, specifically, the understanding of the mechanisms of fragmentation (proteolytic cleavage) in blood serum, as well as of the filtration (transportation) of fragments of troponin molecules through the blood-tissue filters will increase the diagnostic value of troponins in other biological fluids. The purpose of the present article is to examine the metabolic pathway of cardiac troponins and its significance for laboratory diagnostics. The article successively presents the main stages of the metabolic pathway of cardiac troponins (release from cells, circulation, elimination) and potential factors that may influence these mechanisms and, therefore, the diagnostic value of cardiac troponins.Keywords: metabolic pathway, cardiac troponins, myocardial infarction, release mechanisms, proteolytic cleavage of cardiac troponins, elimination mechanisms, diagnostic value
