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Syndecan-1: A Review on Its Role in Heart Failure and Chronic Liver Disease Patients' Assessment
Radu-Stefan Miftode1, Ionela-Lăcrămioara Şerban2, Amalia-Stefana Timpau1
1Department of Internal Medicine I (Cardiology), Faculty of Medicine, University of Medicine and Pharmacy "Gr. T. Popa", Iasi 700115, Romania.
Insights
Syndecan-1 is a promising biomarker for assessing both cardiac and liver fibrosis. This molecule
Area of Science:
- Cardiology
- Hepatology
- Biomarker Discovery
Background:
- Cardiac dysfunction in chronic liver disease is often asymptomatic, posing diagnostic challenges.
- Syndecan-1, a transmembrane proteoglycan, is implicated in cardiac and liver fibrosis.
- Its role in inflammation, regeneration, and lipid metabolism is increasingly recognized.
Purpose of the Study:
- To review the mechanisms of syndecan-1's action in cardio-hepatic disorders.
- To explore syndecan-1's potential as a dual biomarker for heart and liver conditions.
- To highlight its diagnostic and prognostic value.
Main Methods:
- Literature review of studies on syndecan-1 in cardiac and liver fibrosis.
- Analysis of syndecan-1's correlation with fibrosis severity and disease activity.
- Examination of its involvement in molecular pathways like angiotensin II activity.
Main Results:
- Syndecan-1 levels correlate with cardiac and liver fibrosis.
- It plays a role in atherogenesis, inflammation, and tissue repair.
- Soluble syndecan-1 may inhibit fibrosis and influence lipid metabolism.
Conclusions:
- Syndecan-1 shows potential as a noninvasive biomarker for both cardiac and liver fibrosis.
- Further research is warranted to establish its clinical utility in cardio-hepatic disease management.
- Its dual cardio-hepatic role offers new diagnostic and prognostic perspectives.
Abstract:
The close connection and interaction between the cardiac and the liver functions are well-known, as cirrhotic cardiomyopathy is an important clinical entity which best describes the mutual pathogenical influence between these two organs. Due to the fact that cardiac dysfunction in patients with chronic hepatic disorders is oligosymptomatic or even asymptomatic, an early diagnosis represents a challenge for every physician. Syndecan-1-a transmembrane proteoglycan that exerts its functions mainly via its heparane sulfate chains-is a very promising biomarker, correlated not only with the degree of cardiac fibrosis but also with the severity of liver fibrosis. Many studies highlighted its role in the development of cardiac fibrosis or atherogenesis, being significantly correlated with the activity of angiotensin II. Multiple evidence revealed that syndecan-1 is also associated with tissue injury and may regulate inflammatory and regenerative responses, being considered a protective molecule that limits the inflammation and reduces cardiac remodelling and dysfunction after a myocardial infarction. Syndecan-1 may also be used as a reliable biomarker for the noninvasive assessment of liver fibrosis. Under various fibrogenetic conditions, shedding of syndecan's extracellular domain took place, becoming a soluble form that binds different growth factors and inhibits further fibrosis. This complex molecule is also involved in the lipid metabolism, by altering the clearance of cholesterol particles, and in chronic hepatitis, by enhancing the viral invasion of hepatocytes. Due to the growing interest in this biomarker, multiple studies aimed at revealing syndecan-1's potential benefits in the diagnosis and prognosis assessment in patients with heart failure or chronic liver disorders. In this review, we review the mechanisms by which syndecan-1 exerts its effects and the possible perspectives opened by its use as a dual cardio-hepatic biomarker.
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