Implications of pentraxin 3 levels in patients with acute aortic dissection

Abstract

Acute aortic dissection (AAD) causes transient inflammation with occasional pleural fluid (PF) accumulation. Although pentraxin 3 (PTX3) is a vascular inflammation-related biomarker, little is known about PTX3 levels in patients with AAD. We explored the serial changes in plasma PTX3 levels and the association of peak levels with the amount of PF accumulation. Consecutive patients (n = 41) with Stanford type B AAD were enrolled, and blood samples for the measurements of serum albumin, plasma PTX3 and high-sensitivity C-reactive protein (CRP) were collected daily until 7 days after symptom onset. PF accumulation on computed tomography imaging on the third hospital day was divided into 3 grades (I: none or slight, II: mild in the uni- or bilateral pleural cavity, III: moderate or more). PTX3 and CRP levels were analyzed after logarithmic transformation because of their skewed distributions. Peak PTX3 and CRP levels were observed at 4.3 ± 2.1 and 4.7 ± 2.0 days after symptom onset, and their values were 12.2 [interquartile range (IQR), 8.2-20.9] ng/mL and 12.0 (IQR, 8.6-15.2) mg/dL, respectively. On univariate analysis, the peak level of PTX3 had a negative correlation with the minimum level of serum albumin, and a positive correlation with PF grade and duration of intensive care unit stay. On multivariate analysis, the peak level of PTX3 was correlated with PF grade (P = 0.037). In conclusion, the peak level of PTX3 in patients with AAD was associated with the amount of transient PF accumulation, which may be associated with inflammatory vascular permeability.

Association of Plasma Pentraxin-3 Levels on Admission with In-hospital Mortality in Patients with Acute Type A Aortic Dissection

“…Arao et al . [11] have recently explored the association of plasma PTX3 levels with the amount of pleural fluid accumulation in Stanford Type B AD patients. Their results demonstrated that the peak PTX3 level in patients with AAD was associated with the amount of transient pleural fluid accumulation.…”

“…[11] This is because these inflammatory markers are produced differently. CRP is a short pentraxin produced in the liver in response to IL-6, whereas PTX3 is a long pentraxin produced by inflammatory and immune cells in response to IL-1.…”

“…Dyslipidemia was defined by medical history or the use of lipid-lowering medications to reduce lipid levels or fasting serum low-density lipoprotein levels >140 mg/dl. [11]…”

Is pentraxin 3 a biomarker, a player, or both in the context of coronary atherosclerosis and metabolic factors?

“…PTX-3 is expressed in advanced atherosclerotic lesions and is associated with cardiovascular risk factors [1], acute aortic dissection [2] and atrial fibrillation [3]. CRP is mainly produced by hepatocytes under inflammatory stimulation, whereas PTX-3 is directly produced by macrophages, endothelial cells, and smooth muscle cells [4].…”

Biomarkers in descending thoracic aortic dissection

“…Of interest, plasma Pentraxin 3 levels were associated with the amount of transient pleural fluid accumulation. Although at this time, the role of this biomarker in AD is not fully understood, it has been shown to be elevated in patients with acute lung injury, acute respiratory distress syndrome, and septic shock [25].…”