Soluble elastin fragments in serum are elevated in acute aortic dissection.
OBJECTIVE
We aimed to establish an enzyme-linked immunosorbent assay for measuring soluble elastin fragments (sELAF) in serum and to reveal its usefulness in diagnosing acute aortic dissection (AAD).


RESULTS
An enzyme-linked immunosorbent assay to measure sELAF in serum was developed by using the newly created double monoclonal antibodies, which recognize the different epitopes of human aortic elastin. Twenty-five AAD patients, 50 patients with acute myocardial infarction (AMI), and 474 healthy individuals were enrolled in the study. The sELAF levels from healthy subjects gradually increased with aging. When the cutoff point for positivity was set at the mean+3 SD (ie, 3 SD above the mean in healthy subjects at each age), 16 AAD patients (64.0%) were found be positive, whereas only 1 AMI patient was found to be positive (2.0%). AAD patients with either an open or a partially open pseudolumen were found be 88.9% positive for sELAF, whereas those with its early closure were 0% positive. The difference in the sELAF levels between AAD patients with and without a thrombotic closure of false lumen was significant (60.3+/-15.6 versus 135.4+/-53.2 ng/mL, respectively; P<0.005).


CONCLUSIONS
The sELAF level in serum may be a useful marker for helping in the diagnosis and screening of AAD and may also help to distinguish AAD from AMI.
Shinohara
Tadashi
T
Department of Internal Medicine I, National Defense Medical College, Saitama, Japan. kogen@me.ndmc.ac.jp
Suzuki
Kimihiro
K
Okada
Makoto
M
Shiigai
Masaru
M
Shimizu
Masashi
M
Maehara
Tadaaki
T
Ohsuzu
Fumitaka
F
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000097:blood / Q000175:diagnosis*; D001014:Aortic Aneurysm / Q000097:blood / Q000175:diagnosis*; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D003937:Diagnosis, Differential; D004549:Elastin / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis*; D012016:Reference Values; D012307:Risk Factors
D015415:Biomarkers; D004549:Elastin