Hortmann, Marcus, Robinson, Samuel, Mohr, Moritz, Mauler, Maximillian, Stallmann, Daniela, Reinoehl, Jochen, Duerschmied, Daniel, Peter, Karlheinz, Carr, James, Gibson, C. Michael, Bode, Christoph and Ahrens, Ingo (2019). The mitochondria-targeting peptide elamipretide diminishes circulating HtrA2 in ST-segment elevation myocardial infarction. Eur. Heart J.-Acute Cardiovasc. Care, 8 (8). S. 695 - 703. LONDON: SAGE PUBLICATIONS LTD. ISSN 2048-8734

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Abstract

Background: The extent of myocardial damage in patients with ST-segment elevation myocardial infarction (STEMI) depends on both the time to reperfusion as well as injury induced by ischaemia-reperfusion resulting in a cascade of cellular and humoral reactions. As a consequence of ischaemia-reperfusion in the heart, the high-temperature requirement serine peptidase 2 (HtrA2) is translocated from the mitochondria to the cytosol, whereupon it induces protease activity-dependent apoptosis mediated via caspases. Myocardial damage induced by reperfusion cannot be monitored due to a current lack in specific biomarkers. We examined the serum level of HtrA2 as a potentially novel biomarker for mitochondrial-induced cardiomyocyte apoptosis. Methods: After informed consent, peripheral blood was obtained from patients (n=19) with first-time acute anterior STEMI after percutaneous coronary intervention. Within this group, 10 of the patients received the mitochondria-targeting peptide elamipretide (phase 2a clinical study EMBRACE (NCT01572909)). Blood was also obtained from a control group of healthy donors (n=16). The serum level of HtrA2 was measured by an enzyme-linked immunosorbent assay (ELISA). In a murine model of myocardial ischaemia-reperfusion injury, HtrA2 was determined in plasma by ELISA after left anterior descending artery occlusion. Results: HtrA2 median was significantly increased in patients with STEMI compared to healthy controls 392.4 (240.7-502.8) pg/mL vs. 1805.5 (981.3-2220.1) pg/mL (P <= 0.05). Elamipretide significantly reduced the HtrA2 median serum level after myocardial infarction 1805.5 (981.3-2220.1) pg/mL vs. 496.5 (379.4-703.8) pg/mL (P <= 0.05). Left anterior descending artery occlusion in mice significantly increased HtrA2 mean in plasma (117.4 fg/ml +/- SEM 28.1 vs. 525.2 fg/ml +/- SEM 96; P <= 0.05). Conclusion: Compared to healthy controls, we found significantly increased serum levels of HtrA2 in patients with STEMI. The result was validated in a murine model of myocardial ischaemia-reperfusion injury. In humans the increased serum level was significantly reduced by the mitochondria-targeting peptide elamipretide. In conclusion, HtrA2 is detectable in serum of patients with STEMI and might present a novel biomarker for mitochondrial-induced cardiomyocyte apoptosis. Consequently, HtrA2 may also show promise as a biomarker for the identification of ischaemia-reperfusion injury. However, this must be validated in a lager clinical trial.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Hortmann, MarcusUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Robinson, SamuelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mohr, MoritzUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mauler, MaximillianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Stallmann, DanielaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Reinoehl, JochenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Duerschmied, DanielUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Peter, KarlheinzUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Carr, JamesUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gibson, C. MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bode, ChristophUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ahrens, IngoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-126011
DOI: 10.1177/2048872617710789
Journal or Publication Title: Eur. Heart J.-Acute Cardiovasc. Care
Volume: 8
Number: 8
Page Range: S. 695 - 703
Date: 2019
Publisher: SAGE PUBLICATIONS LTD
Place of Publication: LONDON
ISSN: 2048-8734
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
REPERFUSION INJURY; CYTOCHROME-C; CELL-DEATH; OMI/HTRA2; APOPTOSIS; ISCHEMIA; RELEASEMultiple languages
Cardiac & Cardiovascular SystemsMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/12601

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