人体的许多分子执行关键的调节功能,并广泛用作治疗药物开发的靶标或用作特异性诊断标记。这些分子经历了一个重要的代谢途径,在此期间,它们受到许多因素的影响(生物学特征,荷尔蒙,酶,等。)会影响分子代谢,因此,这些分子的血清浓度或活性。在心脏病学领域中最重要的分子是心脏特异性肌钙蛋白(Tns)的分子,它调节心肌收缩/舒张过程,并用作心肌梗死(MI)中心肌细胞缺血性坏死(CMC)的早期诊断标志物。在新的(高灵敏度(HS))检测方法出现后,心脏特异性Tns的诊断价值和诊断能力发生了显着变化。因此,MI的早期诊断算法被批准用于临床实践,由此开启了快速诊断和确定治疗MI患者的最佳策略的可能性。相对最近,在心血管疾病(CVD)(动脉高血压(AH),心力衰竭(HF),冠心病,等。),以及可能对CMC产生负面影响的非缺血性心脏外病理(例如,脓毒症,慢性肾脏病(CKD),慢性阻塞性肺疾病(COPD),等。).最近的研究还表明,心脏特异性Tns不仅存在于血清中,但也在其他生物流体(尿液,口服液,心包液,羊水)。因此,心脏特异性Tns具有额外的诊断能力。然而,心脏特异性Tns的代谢途径的基本方面是明确未知的,特别是,在非缺血性心外病变中从CMC释放Tns的特定机制,循环和从人体中消除TNS的机制,Tns向其他生物流体的转运机制和可能影响这些过程的因素尚未建立。在这份全面的手稿中,代谢途径的所有阶段都被一致和详细地考虑,从CMC释放开始,以人体排泄(去除)结束。此外,个体阶段和机制的可能诊断作用,分析了影响因素,并指出了该领域进一步研究的方向。
Many molecules of the human body perform key regulatory functions and are widely used as targets for the development of therapeutic drugs or as specific diagnostic markers. These molecules undergo a significant metabolic pathway, during which they are influenced by a number of factors (biological characteristics, hormones, enzymes, etc.) that can affect molecular metabolism and, as a consequence, the serum concentration or activity of these molecules. Among the most important molecules in the field of cardiology are the molecules of cardiospecific troponins (Tns), which regulate the processes of myocardial contraction/relaxation and are used as markers for the early diagnosis of ischemic necrosis of cardiomyocytes (CMC) in myocardial infarction (MI). The diagnostic value and diagnostic capabilities of cardiospecific Tns have changed significantly after the advent of new (highly sensitive (HS)) detection methods. Thus, early diagnostic algorithms of MI were approved for clinical practice, thanks to which the possibility of rapid diagnosis and determination of optimal tactics for managing patients with MI was opened. Relatively recently, promising directions have also been opened for the use of cardiospecific Tns as prognostic markers both at the early stages of the development of cardiovascular diseases (CVD) (arterial hypertension (AH), heart failure (HF), coronary heart disease (CHD), etc.), and in non-ischemic extra-cardiac pathologies that can negatively affect CMC (for example, sepsis, chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD), etc.). Recent studies have also shown that cardiospecific Tns are present not only in blood serum, but also in other biological fluids (urine, oral fluid, pericardial fluid, amniotic fluid). Thus, cardiospecific Tns have additional diagnostic capabilities. However, the fundamental aspects of the metabolic pathway of cardiospecific Tns are definitively unknown, in particular, specific mechanisms of release of Tns from CMC in non-ischemic extra-cardiac pathologies, mechanisms of circulation and elimination of Tns from the human body, mechanisms of transport of Tns to other biological fluids and factors that may affect these processes have not been established. In this comprehensive manuscript, all stages of the metabolic pathway are consistently and in detail considered, starting from release from CMC and ending with excretion (removal) from the human body. In addition, the possible diagnostic role of individual stages and mechanisms, influencing factors is analyzed and directions for further research in this area are noted.