Diagnostic and prognostic role of cardiac pathology multicomplex autoimmune biological markers

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Abstract

Relevance . Despite the large list of biological markers of cardiovascular diseases, not all have evidence-b ased effectiveness and independent prognostic value. Laboratory diagnostics of serum cardiospecific auto-antibodies for the diagnosis of myocyte cell damage has several potential advantages compared to the evaluation of traditional methods. These include the analysis of natural globulins to troponin I (cTnI), to alpha-a ctin 1 (ACTC1), to the heavy chain of beta-myosin 7B (MUN7B), which are based on a self-sustaining immune response to the myocardium’s own auto-antigens, which leads to damage to the cells expressing them. Purpose: To determine the diagnostic and practical value of quantitative indicators for the autoantibody complex to cardiomyocyte proteins to troponin I, to alpha-a ctin 1 and to the heavy chain of beta-myosin 7B in patients with cardiac pathology. Materials and Methods. The study of auto-antibodies to cTnI, ACTC1 and MUN7B in blood serum using laboratory enzyme immunoassay was carried out in patients with cardiac pathology undergoing inpatient treatment at the Regional Clinical Cardiology Dispensary in Stavropol. Additionally, an instrumental and laboratory examination was carried out in accordance with the clinical recommendations developed by the Association of Cardiovascular Surgeons, the Cardiological Society of Russia and approved by the Scientific and Practical Council of the Ministry of Health of the Russian Federation. The work was examined and approved by the Ethics Committee of the North Caucasus Federal University. Results and Discussion . Changes in the level of autoantibodies to cTnI, ACTC1 and MUN7B proteins in blood serum were statistically significant (p < 0.01 v. s. p < 0.01). A persistent increase in the level of auto-antibodies to cTnI by 2.36 ng/ml (694.11 %), to ACTC1 by 3.6 ng/ml (141.73 %) and to MUN7B by 1.74 ng/ml (119.17 %) was found in individuals with confirmed cardiac pathology, when other criteria for laboratory analysis were within acceptable values, which determine their diagnostic and evidentiary effectiveness. Conclusion . The results of the study showed the relationship of changes in the activity of cardiospecific auto-A T to cardiomyocyte proteins (Anti-cTnI, Anti ACTC1, Anti-M YH7B) in patients with cardiac pathologies, indicating not only systemic membrane disorders (membranopathies), but also serve as convincing evidence of direct chemical changes in cardiomyocytes. A correlation has also been established between cardiomarkers of necrosis and ischemia and autoimmune globulins Anti-cTnI, Anti ACTC1, Anti-MYH7B, that confirms diagnostic and practical value of this laboratory analysis.

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Table 1. Comparative characteristics of laboratory parameters of the hematological profile

Indicators

Units of measurement

Reference values

Group I (n = 30)

Group II (n = 20)

HGB

g/L

130–160

153.4  ±  25.88

159  ±  12.5

RBC

*10¹²/ L

4–5

5.10  ±  0.63

5.30  ±  0.39

MHC

pg

27–31

30.17  ±  2.23

29.82  ±  1.23

PLT

*109/ L

180–320

194  ±  43.31

257  ±  53.8

WBC

*109/ L

4–9

9.8  ±  2.10

6.5  ±  1.4

SOE

Mm/h

2–10

16.25  ±  6.23

2.3  ±  1.5

р

 

 

<  0.01

<  0.01

Note: * p — the reliability of the differences.

Table 2. Comparative characteristics of laboratory parameters of hormonal status

Indicators

Units of measurement

Reference values

Group I (n = 30)

Group II (n = 20)

TSH

mME/L

0,3–4,0

2.28  ±  1.04

1.957  ±  0.19

FT4

Nmol/l

10,0–23,2

16.07  ±  1.59

18.2  ±  2.23

TT3

Nmol/l

1,0–2,8

1.86  ±  0.48

2.02  ±  0.52

Testosterone

ng/dl

175–780

355.3  ±  27.42

610.2  ±  118.0

р

 

 

<  0.01

<  0.01

Note: * p — the reliability of the differences.

Table 3. Comparative characteristics of laboratory parameters of markers of necrosis and ischemia in blood serum

Indicators

Units of measurement

Reference values

Group I (n = 30)

Group II (n = 20)

р

CPK

UNITS/l

50–190

86.75 ± 34.12

61.23 ± 19.6

0.015

CPK-MB

UNITS/l

< 24

12.67 ± 3.01

6.0 ± 1.56

0.025

LDH

UNITS/l

225–450

308.1 ± 46.3

239 ± 36.2

0.022

Myoglobin

ng/l

< 80

8.07 ± 0.95

2.6 ± 0.12

0.016

сТн I

ng/l

< 20

2.1 ± 0.11

1.0 ± 0.09

0.008

Note: p — the reliability of the differences.

Table 4 Comparative characteristics of laboratory parameters of cardiospecific autoantibodies (auto-AT)  to troponin I, to alpha-actin 1, to the heavy chain of beta-myosin 7B

Indicators

Units of measurement

Group I (n = 30)

Group II (n = 20)

р

Auto-antibodies to troponin I

ng/ml

2.7 ± 0.73

0.34 ± 0.08

0.015

Auto-antibodies to alpha-a ctin 1

ng/ml

6.14 ± 2.876

2.54 ± 1.89

0.023

Auto-antibodies to the beta-myosin heavy chain

ng/ml

3.2 ± 0.306

1.46 ± 0.99

0.033

Note: p — the reliability of the differences.

×

About the authors

Elvira D. Lovochkina

North Caucasus Federal University

Author for correspondence.
Email: Minaeva-Elvira1990@yandex.ru
ORCID iD: 0000-0002-1996-0920
Stavropol, Russian Federation

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