A recent article published in Vascular News highlights the importance of plasma desmosine, an elastin component, that provides elasticity for tissue. A breakdown of elastin leads to aortic dilatation and rupture. If desmosine is found in plasma, urine, or sputum, it is generally an indication of disease.
Dr. Maaz Syed of Edinburgh University in the UK was a speaker at the annual meeting of scientists in Manchester, UK. The doctor presented a report from a British Heart Foundation study on acute aortic syndromes (AAS). He described the disease as being unpredictable and catastrophic. The NIH describes AAS as being life-threatening vascular events in the thoracic aorta. The primary symptom is acute pain.
The theme of Dr. Syed’s presentation was that plasma desmosine has the potential of being a biomarker of acute aortic syndrome. Biomarker is a general term for molecules in the blood or in other body tissues and fluids. These may be signs of an abnormal or normal process or simply of a disease or condition.
Although no acute aortic syndrome patients have ever been tested, Dr. Syed noted that scientists have been aware that the disease brings high levels of desmosine.
About the AAS Study
The aorta runs through the heart and center of the abdomen. It is a critical organ as it provides blood to the body. When an abdominal aortic aneurysm occurs, the lower section of the aorta becomes enlarged. As of yet, there is no cure for acute aortic syndrome.
The clinical trial investigators studied concentrations of plasma desmosine in fifty-three patients who had been diagnosed with acute aortic syndrome. According to Dr. Syed, these results were analyzed against one hundred-six healthy patients (controls).
The groups were fairly well matched with the exception that the acute aortic syndrome group was being treated with hypertension medication. Therefore, their blood pressure was somewhat lower than the control group. Other minor differences were age (lower in the control group) and gender (fewer males in the control group).
As the researchers had anticipated, levels of plasma desmosine were higher in AAS patients when compared against controls. This applies against three AAS sub-types namely:
- Aortic dissections: ulcers form from plaque that disrupts the artery wall lining; this causes a tear in the aorta resulting in volumes of blood escaping; the middle layers of the aorta split
- Penetrating aortic ulcers: previously diagnosed as aortic dissections due to its similarity, it is now in a separate category as there is no flap on the innermost layer of the aorta
- Intramural hematomas: the aortic wall’s innermost layer is breached and blood flows between that layer and the outer walls. Since in this instance there is no tear in the aortic wall, until recently, the condition was challenging to diagnose
The new study appears to agree with an earlier study whereby concentrations of plasma desmosine predict disease severity and clinical outcomes in AAS patients.
In conclusion, Dr. Syed reported the researchers’ findings that plasma desmosine increased during episodes of AAS and could be detected within twenty-four hours of the onset of the disease. He went on to say that these findings demonstrate the potential for plasma desmosine as a useful diagnostic tool in the ER. Dr. Syed acknowledged that a multicenter collaboration is needed.
Other discussions followed the presentation. One attendee asked if there was any data on plasma desmosine levels and connective tissue disorders.
Dr. Syed did, in fact, have evidence in one instance of Marfan syndrome that there was a five to six-fold increase in a patient’s plasma desmosine. The doctor said that this case led to current testing for plasma desmosine in patients who have connective tissue disease.
