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Teaching an old dog new tricks: serum troponin T as a biomarker in amyotrophic lateral sclerosis

Amyotrophic lateral sclerosis is a devastating neurodegenerative disease characterized by progressive loss of upper and lower motor neurons. Diagnosis, management and therapeutic trials are hampered by a lack of informative biomarkers. Troponins are components of skeletal and cardiac muscles. Acute...

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Autores principales: Castro-Gomez, Sergio, Radermacher, Barbara, Tacik, Pawel, Mirandola, Sandra R, Heneka, Michael T, Weydt, Patrick
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8728713/
https://www.ncbi.nlm.nih.gov/pubmed/34993474
http://dx.doi.org/10.1093/braincomms/fcab274
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author Castro-Gomez, Sergio
Radermacher, Barbara
Tacik, Pawel
Mirandola, Sandra R
Heneka, Michael T
Weydt, Patrick
author_facet Castro-Gomez, Sergio
Radermacher, Barbara
Tacik, Pawel
Mirandola, Sandra R
Heneka, Michael T
Weydt, Patrick
author_sort Castro-Gomez, Sergio
collection PubMed
description Amyotrophic lateral sclerosis is a devastating neurodegenerative disease characterized by progressive loss of upper and lower motor neurons. Diagnosis, management and therapeutic trials are hampered by a lack of informative biomarkers. Troponins are components of skeletal and cardiac muscles. Acute elevation of cardiac isoforms of troponin I and T in serum indicates myocardial injury. Case reports suggested that serum levels of cardiac troponin T, but not cardiac troponin I are chronically elevated in myotrophic lateral sclerosis and other neuromuscular disorders. Using standard clinical laboratory methodologies, we studied serum troponin levels in a multicentric cross-sectional cohort of 75 amyotrophic lateral sclerosis patients and 30 Alzheimer’s disease controls and 29 healthy controls (DESCRIBE-ALS cohort) and in a real-world cohort of 179 consecutive patients from our amyotrophic lateral sclerosis clinic at the University Hospital Bonn. We found that serum cardiac troponin T is elevated in >60% of amyotrophic lateral sclerosis patients, while cardiac troponin I is always normal. Serum cardiac troponin T levels increase over time and correlate with disease severity as measured with the revised Amyotrophic Lateral Sclerosis Functional Rating Scale score. There was no correlation with the phosphorylated neurofilament heavy chain levels in the cerebrospinal fluid. We propose that cardiac troponin T elevations in amyotrophic lateral sclerosis are of non-cardiac origin and may serve as a proxy of lower motor neuron or skeletal muscle involvement. They potentially help to stratify patients according to lower motoneuron involvement. Further research will determine the biological origin of the cardiac troponin T elevation and its validity as a diagnostic and/or prognostic marker. Our finding also serves as a reminder to interpret cardiac troponin T elevations in patients with neuromuscular diseases with caution.
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spelling pubmed-87287132022-01-05 Teaching an old dog new tricks: serum troponin T as a biomarker in amyotrophic lateral sclerosis Castro-Gomez, Sergio Radermacher, Barbara Tacik, Pawel Mirandola, Sandra R Heneka, Michael T Weydt, Patrick Brain Commun Original Article Amyotrophic lateral sclerosis is a devastating neurodegenerative disease characterized by progressive loss of upper and lower motor neurons. Diagnosis, management and therapeutic trials are hampered by a lack of informative biomarkers. Troponins are components of skeletal and cardiac muscles. Acute elevation of cardiac isoforms of troponin I and T in serum indicates myocardial injury. Case reports suggested that serum levels of cardiac troponin T, but not cardiac troponin I are chronically elevated in myotrophic lateral sclerosis and other neuromuscular disorders. Using standard clinical laboratory methodologies, we studied serum troponin levels in a multicentric cross-sectional cohort of 75 amyotrophic lateral sclerosis patients and 30 Alzheimer’s disease controls and 29 healthy controls (DESCRIBE-ALS cohort) and in a real-world cohort of 179 consecutive patients from our amyotrophic lateral sclerosis clinic at the University Hospital Bonn. We found that serum cardiac troponin T is elevated in >60% of amyotrophic lateral sclerosis patients, while cardiac troponin I is always normal. Serum cardiac troponin T levels increase over time and correlate with disease severity as measured with the revised Amyotrophic Lateral Sclerosis Functional Rating Scale score. There was no correlation with the phosphorylated neurofilament heavy chain levels in the cerebrospinal fluid. We propose that cardiac troponin T elevations in amyotrophic lateral sclerosis are of non-cardiac origin and may serve as a proxy of lower motor neuron or skeletal muscle involvement. They potentially help to stratify patients according to lower motoneuron involvement. Further research will determine the biological origin of the cardiac troponin T elevation and its validity as a diagnostic and/or prognostic marker. Our finding also serves as a reminder to interpret cardiac troponin T elevations in patients with neuromuscular diseases with caution. Oxford University Press 2021-11-17 /pmc/articles/PMC8728713/ /pubmed/34993474 http://dx.doi.org/10.1093/braincomms/fcab274 Text en © The Author(s) (2021). Published by Oxford University Press on behalf of the Guarantors of Brain. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Castro-Gomez, Sergio
Radermacher, Barbara
Tacik, Pawel
Mirandola, Sandra R
Heneka, Michael T
Weydt, Patrick
Teaching an old dog new tricks: serum troponin T as a biomarker in amyotrophic lateral sclerosis
title Teaching an old dog new tricks: serum troponin T as a biomarker in amyotrophic lateral sclerosis
title_full Teaching an old dog new tricks: serum troponin T as a biomarker in amyotrophic lateral sclerosis
title_fullStr Teaching an old dog new tricks: serum troponin T as a biomarker in amyotrophic lateral sclerosis
title_full_unstemmed Teaching an old dog new tricks: serum troponin T as a biomarker in amyotrophic lateral sclerosis
title_short Teaching an old dog new tricks: serum troponin T as a biomarker in amyotrophic lateral sclerosis
title_sort teaching an old dog new tricks: serum troponin t as a biomarker in amyotrophic lateral sclerosis
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8728713/
https://www.ncbi.nlm.nih.gov/pubmed/34993474
http://dx.doi.org/10.1093/braincomms/fcab274
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