Plasma Exosome Profile in ST-Elevation Myocardial Infarction Patients with and without Out-of-Hospital Cardiac Arrest

Abstract

The identification of new biomarkers allowing an early and more accurate characterization of patients with ST-segment elevation myocardial infarction (STEMI) is still needed, and exosomes represent an attractive diagnostic tool in this context. However, the characterization of their protein cargo in relation to cardiovascular clinical manifestation is still lacking. To this end, 35 STEMI patients (17 experiencing resuscitated out-of-hospital cardiac arrest (OHCA-STEMI) and 18 uncomplicated) and 32 patients with chronic coronary syndrome (CCS) were enrolled. Plasma exosomes were characterized by the nanoparticle tracking analysis and Western blotting. Exosomes from STEMI patients displayed a higher concentration and size and a greater expression of platelet (GPIIb) and vascular endothelial (VE-cadherin) markers, but a similar amount of cardiac troponin compared to CCS. In addition, a difference in exosome expression of acute-phase proteins (ceruloplasmin, transthyretin and fibronectin) between STEMI and CCS patients was found. GPIIb and brain-associated marker PLP1 accurately discriminated between OHCA and uncomplicated STEMI. In conclusion, the exosome profile of STEMI patients has peculiar features that differentiate it from that of CCS patients, reflecting the pathophysiological mechanisms involved in STEMI. Additionally, the exosome expression of brain- and platelet-specific markers might allow the identification of patients experiencing ischemic brain injury in STEMI.

Proteomics analyses of five potential plasma-derived exosomal biomarkers for acute myocardial infarction

“…Plasma exosomes participate in the in ammatory immune response in acute myocardial infarction 20 . Acute myocardial infarction patients' protein expression in the blood is distinct from that of patients with SAP 21 . Exosomes of MSCs isolated from human umbilical cord blood have cardioprotective effects in animal models of AMI and cardiomyocyte hypoxia injury 22 , as reported by Marta Zarà et al 22 .…”

Increased serum extracellular vesicle miR-144-3p and miR-486a-3p in a mouse model of adipose tissue regeneration promote hepatocyte proliferation by targeting Txnip

“…Secreted EVs are taken up by other cells, and cargo molecules have a wide range of functions in the recipient cells [ 8 ]. Among the cargos of EVs, microRNAs (miRNAs) have attracted attention as they are currently known to be involved in the development and progression of various diseases, such as cancer, cardiovascular disease, and metabolic disorders [ 9 , 10 , 11 ]. miRNAs are single-stranded non-coding RNAs consisting of around 22 bases; they regulate gene expression by inhibiting the translation or degradation of mRNAs that have sequences complementary to miRNAs in the 3’-untranslated region (3’-UTR) [ 12 , 13 ].…”

Circulating Small Extracellular Vesicles Reflect the Severity of Myocardial Damage in STEMI Patients

“…Mainly known for their central role in local/distant intercellular communication, the growing knowledge about sEVs has highlighted their potential as a rich source of biomarkers for several diseases [3,4]. We have recently shown that the number and size of plasma sEVs are higher in acute STEMI patients compared to chronic coronary syndrome (CCS) [5]. Moreover, STEMI sEVs are characterized by a greater expression of platelet markers [5], suggesting a critical role for platelet-derived sEVs in AMI.…”