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Soluble CD146 in Heart Failure: Pathophysiological Role and Diagnostic Potential
Daniela Mocan1,2,3,4, Radu Jipa5,6, Daniel Alexandru Jipa7,8
1Multidisciplinary Doctoral School, Vasile Goldis Western University of Arad, 310025 Arad, Romania.
Insights
Soluble CD146 (sCD146) shows promise as a biomarker for heart failure (HF), reflecting congestion and endothelial stress. However, its clinical use requires standardization due to variability and non-cardiac influences.
Area of Science:
- Cardiology
- Biomarker Discovery
- Vascular Biology
Background:
- Heart failure (HF) is a complex condition with systemic effects.
- Current biomarkers like natriuretic peptides do not fully represent vascular dysfunction in HF.
- CD146 (MCAM) is an endothelial cell glycoprotein involved in vascular processes.
Purpose of the Study:
- To review the structure, regulation, and release of CD146.
- To explore the clinical utility of soluble CD146 (sCD146) as a biomarker in HF.
- To assess sCD146's potential in reflecting hemodynamic congestion and endothelial stress.
Main Methods:
- Literature review synthesizing current knowledge on CD146 and sCD146.
- Analysis of studies associating sCD146 levels with HF indicators and outcomes.
- Evaluation of sCD146's release mechanisms under pathophysiological stimuli.
Main Results:
- Elevated sCD146 levels correlate with congestion indicators (echocardiography, radiology) in HF.
- sCD146 has been linked to adverse outcomes in HF patients.
- sCD146 release is stimulated by endothelial stretch, oxidative stress, and inflammation.
Conclusions:
- sCD146 is a promising biomarker for HF, reflecting congestion and endothelial stress.
- Clinical application is hindered by variability, lack of standardization, and confounding factors like malignancy.
- Further research is needed to standardize sCD146 measurement and clarify its role in HF.
Abstract:
Heart failure (HF) remains a major global health challenge, driven by multifactorial pathophysiological processes, such as systemic congestion, endothelial dysfunction, and inflammation. While natriuretic peptides are well-established biomarkers for diagnosing and monitoring HF, they do not fully capture the complexity of vascular involvement. CD146, also known as melanoma cell adhesion molecule (MCAM), is a transmembrane glycoprotein primarily expressed on endothelial cells and involved in cell adhesion, vascular permeability, and angiogenesis. Its soluble form (sCD146), released in response to multiple pathophysiological stimuli, including venous and arterial endothelial stretch, oxidative stress, and inflammatory cytokine activation, has emerged as a promising biomarker reflecting both hemodynamic congestion and systemic endothelial stress. This review synthesizes current knowledge on the structure, regulation, and release mechanisms of CD146 and explores its clinical utility in HF. Elevated sCD146 levels have been associated with echocardiographic and radiological indicators of congestion, as well as with adverse outcomes. While promising, its application is limited by variability, lack of standardization, and confounding elevations in non-cardiac conditions, including malignancy.
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