Характеристика основних біомаркерів ішемічного ураження м’язової тканини

The ischemia forms the basis of pathogenetic mechanisms acute and chronic heart diseases and blood vessels diseases. Ischemic heart disease causes the highest mortality. The activation a number of kinases playes an important role in establishing complex cells interconnections to achieve biological effects in the response to ischemic injury. Various protein nature factors are synthesized and isolated in the bloodstream owing to reactions cascade induced by kinases. The most studied are natriuretic peptides, cardiac troponins, and various growth factors. They are used as diagnostic markers of myocardial damage. The most accurate markers are natriuretic peptides and cardiac troponins. In particular, natriuretic peptides depress the renin-angiotensin and sympatho-adrenal system, and also have diuretic effects. Cardiac troponins are isolated exclusively from the myocardium. They are contained in structural and cytosolic pools. They play an important role in reducing Ca2 + sensitivity of force development. There is a number of less studied and significant protein factors that are released during ischemia. Due to its specificity, heart-fatty acid binding protein is the earliest diagnostic marker of myocardial ischemic injury. Creatine Kinase-MB has negative effects during excessive physical activity due to high interstitial fluid permeability. Stimulating growth factor is closely related to interleukin-33, which provides cardioprotective effect. The growth-differentiation factor-15 (GDF-15) is synthesized on the myocardium cell membranes surface in response to ischemia-reperfusion. It is involved in the processes of myocardial recovery and fibrosis. The vascular endothelial growth factor stimulates the cellular response by binding to the appropriate receptors on the cellular muscle fiber membrane, in the sarcoplasm and the nuclear membranes of the ischemic muscle. Altogether with GDF-15, it protects the heart from ischemia-reperfusion injury by the signaling kinase path PI3K-Akt. Today the Fibroblast Growth Factor 23 is considered as a new risk factor for cardiovascular disease. It`s high level may be mediated by left ventricular hypertrophy. Galectin-3 transduces extracellular signal and participates in the processes of acute inflammatory reactions, cardiomyocytes repair, regulation of the apoptosis intensity. The AMP-activated protein kinase is an important regulator of the cellular response pathways in the energy stress conditions. It affects the degree of glucose absorption and glycolysis process. Nowadays, it is important to use a marker complexes for more accurate diagnosis of ischemic damage. The concentration of these protein factors increases in the first hours of damage and depends on damage severity. Some of the protein factors are not specific to the heart tissue and have an effect on skeletal muscle. The systematization of literary data allows us to understand the main links in the mechanism of these factors and what effect they have on the ischemic tissue. The revealed features will be relevant for further research of protein factors effects on the parameters of muscle contraction.