title: Tryptase levels in patients after acute coronary syndromes: the potential new marker of an unstable plaque?
abstract: BACKGROUND
  Mast cells (MCs) are multifunctional immune cells that produce a number of vasoactive or thromboactive mediators. Elevated numbers of human heart MCs are observed in the shoulder regions of coronary atherosclerotic plaques, suggesting that they play a role in plaque rupture. Cardiac MC degranulation after myocardial ischemia has been documented in animal models. Cardiac MCs are highly profibrinolytic cells and release tryptase, their specific protease, after ischemic events.
  
  
  OBJECTIVE
  Mast cell activation and release of tryptase may differentiate among patients with acute coronary syndromes (ACS), potentially determining the clinical course of ACS. Tryptase levels may indirectly reflect the fibrinolytic status of patients.
  
  
  METHODS
  Mast cell activation after ACS was estimated in 10 controls and 52 patients by measuring the serum levels of tryptase in the acute phase, at 2 weeks, and at 3 months after the ACS episode. Total tryptase levels were determined by using the UniCAP system and analyzed with respect to the patients' clinical types of ACS on admission (ACS with persistent ST-segment elevation on electrocardiogram or with ST-segment depression).
  
  
  RESULTS
  Significant differences in serum tryptase levels between the groups were found, with higher serum tryptase concentrations in the ST-segment depression group in the acute phase, and at follow-up.
  
  
  CONCLUSIONS
  Serum tryptase concentration differences among patients with distinct types of ACS may indicate a more important role of human heart MCs in ACS with ST-segment depression pathogenesis. To our knowledge, this is the first report indicating that serum tryptase levels may differentiate patients with distinct types of ACS.
authors.affiliation: Department of Internal Medicine and Cardiology, Warsaw Medical University School, Poland Central University Hospital, Warsaw, Poland. krzysztof.filipiak@amwaw.edu.pl
authors.forename: Krzysztof J
authors.initials: KJ
authors.lastname: Filipiak
authors.forename: Bozena
authors.initials: B
authors.lastname: Tarchalska-Krynska
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Opolski
authors.forename: Adam
authors.initials: A
authors.lastname: Rdzanek
authors.forename: Janusz
authors.initials: J
authors.lastname: Kochman
authors.forename: Dariusz A
authors.initials: DA
authors.lastname: Kosior
authors.forename: Andrzej
authors.initials: A
authors.lastname: Czlonkowski
mesh_terms: D000328:Adult; D015415:Biomarkers; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008407:Mast Cells / Q000201:enzymology*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood*; D012697:Serine Endopeptidases / Q000097:blood*; D013577:Syndrome; D053802:Tryptases
chemical_list: D015415:Biomarkers; D012697:Serine Endopeptidases; D053802:Tryptases