Ceramides: a potential cardiovascular biomarker in young adult childhood cancer survivors?

Area of Science:

• Cardiovascular Science
• Oncology
• Biochemistry

Background:

• Childhood cancer survivors (CCS) face increased risks of late cardiovascular disease (CVD).
• Specific circulating ceramides are implicated in CVD pathophysiology.
• Previous studies identified adverse cardiovascular changes in young adult CCS.

Purpose of the Study:

• To investigate circulating ceramides in young adult CCS.
• To assess correlations between ceramides and previously reported cardiovascular changes in CCS.
• To evaluate the utility of ceramides as biomarkers for CVD risk in CCS.

Main Methods:

• Mass spectrometry analysis of plasma long-chain ceramides (C16:0, C18:0, C24:0, C24:1).
• Calculation of the coronary event risk test 2 (CERT2) score from ceramide data.
• Partial correlation analysis with existing cardiac, carotid artery, and lipid data.

Main Results:

• All four ceramides were significantly elevated in CCS compared to controls.
• C18:0 was 33% higher in CCS (P < 0.001).
• The CERT2 score was higher in CCS (P < 0.001), with 35% having a high score (≥7) versus 9% in controls. Higher CERT2 scores correlated with increased heart rate, blood pressure, apolipoprotein B, arterial stiffness, and cranial radiotherapy exposure.

Conclusions:

• Elevated cardiotoxic ceramides are present in young adult CCS.
• The CERT2 score is a potential indicator of increased CVD risk in CCS.
• Ceramides may serve as important biomarkers for CVD pathophysiology and risk prediction in young adult CCS.