CEACAM1 and MICA as novel serum biomarkers in patients with acute and recurrent pericarditis
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Gal Markel1,2,3, Massimo Imazio4, Nira Koren-Morag5, Gilli Galore-Haskel1, Jacob Schachter1, Michal Besser1,3, Davide Cumetti6, Silvia Maestroni6, Arie Altman7, Yehuda Shoenfeld8, Antonio Brucato6, Yehuda Adler2,9,10
1Ella Lemelbaum Institute of Melanoma, Sheba Medical Center, Tel Hashomer, Israel
2Talpiot Medical Leadership Program, Sheba Medical Center, Tel Hashomer, Israel
3Department of Clinical Microbiology and Immunology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
4Cardiology Department, Maria Vittoria Hospital, Torino, Italy
5Department of Epidemiology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
6Internal Medicine, Ospedali Riuniti, Bergamo, Italy
7Internal Medicine B, Sheba Medical Center, Tel Hashomer, Israel
8Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel
9Cardiac Rehabilitation Institute, Sheba Medical Center, Tel Hashomer, Israel
10Department of Internal Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Yehuda Adler, e-mail: firstname.lastname@example.org
Gal Markel, e-mail: email@example.com
Keywords: pericarditis, serum, biomarkers, MICA, MICB
Received: October 03, 2015 Accepted: January 23, 2016 Published: February 20, 2016
Background: The immune response plays a significant role in pericarditis, but the mechanisms of disease are poorly defined. Further, efficient monitoring and predictive clinical tools are unavailable. Carcinoembryonic antigen cell adhesion molecule 1 (CEACAM1) is an immune-inhibitory protein, while MHC class I chain related protein A (MICA) and B (MICB) have an immune-stimulating function.
Methods and Results: Serum CEACAM1, MICA and MICB concentrations were measured by ELISA in ~50 subjects of each group: acute pericarditis (AP), recurrent pericarditis (RP) and lupus (SLE) patients, metastatic melanoma patients as well as healthy donors. Serum CEACAM1 was dramatically elevated in AP and RP patients, but not in SLE patients, and displayed a highly accurate profile in ROC curve analyses. MICA and MICB were elevated in some pericarditis patients. All markers were enhanced in metastatic melanoma patients irrespective of neoplastic pericardial involvement. Etiology-guided analysis of RP patients showed that very low MICA levels were associated with idiopathic RP, while high MICA was associated with autoimmune and post-operative RP. Importantly, MICA was significantly associated with recurrences, independently of other potentially confounding parameters such as age, time of follow up or treatment modality.
Conclusions: Here we report for the first time on CEACAM1 as a potentially novel biomarker for pericarditis, as well as on MICA as an innovative prognostic marker in these patients. Determination of the roles of these immune factors, as well as their diagnostic and prognostic values should be determined in future prospective studies.
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