Abstract 14123: Human Pentraxin 3 is a Novel Biomarker for Diagnosing Pulmonary Arterial Hypertension
[Background] Inflammation is a feature of pulmonary arterial hypertension (PAH) and levels of increased circulating interleukin 6 (IL-6) correlate with survival of patients with idiopathic PAH. Many PAH patients have systemic inflammatory diseases, however the contribution of elevated cytokines or their potential as biomarkers remains unknown. Human pentraxin 3 (PTX3) is a novel inflammatory marker secreted by vascular endothelial cells, vascular smooth muscle cells and macrophages, and its regulation is independent of the upregulation of systemic inflammatory biomarkers such as C-reactive protein (CRP) and IL-6. This study was designed to investigate whether PTX3 reflects pulmonary vascular inflammation in patients with PAH, and whether it could be used as a novel biomarker for the diagnosis of PAH.
[Methods and Results] We tested the hypothesis that plasma concentration of PTX3 is useful as a biomarker for diagnosing PAH regardless of the complications of systemic inflammatory diseases. Plasma PTX3 levels were evaluated in forty-six PAH patients (idiopathic PAH, n=24; PAH associated with connective tissue disease (CTD-PAH), n=14; congenital heart disease (CHD-PAH), n=8) who received treatment for PAH, thirty-two disease matched connective tissue disease patients without PAH, and age matched healthy controls. Plasma BNP and CRP levels were also evaluated together. The mean PTX3 level across all PAH patients was 4.13 ± 0.32 ng/ml. This was significantly higher than that of healthy controls (2.12±0.70, P<0.05). The mean PTX3 level for CTD-PAH was (5.22 ± 0.78). Not only was this was significantly higher than the mean level for other types of PAH (3.66 ± 0.29, P<0.05), it was also significantly higher than that of connective tissue disease patients without PAH (2.84 ± 0.16, P<0.01). The levels of plasma BNP (117.2 ± 46.9 pg/ml, P=0.434 ) and CRP (0.30 ± 0.12 mg/dl, P=0.949 ) were not significantly correlated with the levels of PTX3.
[Conclusions] This study has illustrated that the level of PTX3 reflects local pulmonary vascular inflammation in patients with PAH regardless of systemic inflammatory disease. It suggests that PTX3 is a novel biomarker for the diagnosis of PAH especially in patients with connective tissue diseases.
- © 2011 by American Heart Association, Inc.