Circulating Biomarkers in Pulmonary Arterial Hypertension: An Update

• Published in: Biomolecules (Basel, Switzerland) Vol. 14; no. 5; p. 552
• Main Authors: Correale, Michele, Tricarico, Lucia, Bevere, Ester Maria Lucia, Chirivì, Francesco, Croella, Francesca, Severino, Paolo, Mercurio, Valentina, Magrì, Damiano, Dini, Frank, Licordari, Roberto, Beltrami, Matteo, Dattilo, Giuseppe, Salzano, Andrea, Palazzuoli, Alberto
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 03.05.2024
• Subjects: Biological markers; biomarker; Biomarkers; Biomarkers - blood; Care and treatment; Clinical outcomes; Diagnosis; Disease; Fibrosis; Heart; Humans; Hypertension; Hypertension, Pulmonary - blood; Hypertension, Pulmonary - diagnosis; Hypoxia; Identification and classification; Lung diseases; Medical screening; Nitric oxide; Oxidative Stress; Patients; Peptides; Prognosis; Prostacyclin; pulmonary arterial hypertension; Pulmonary Arterial Hypertension - blood; Pulmonary Arterial Hypertension - diagnosis; Pulmonary artery; Pulmonary hypertension; Thrombosis; treatment; Vasoconstriction; Working groups; Italy; treatment; diagnosis; biomarker; pulmonary arterial hypertension; pulmonary hypertension
• ISSN: 2218-273X; 2218-273X
• DOI: 10.3390/biom14050552

Pulmonary arterial hypertension (PAH) is a rare subtype of group 1 pulmonary hypertension (PH) diseases, characterized by high pulmonary artery pressure leading to right ventricular dysfunction and potential life-threatening consequences. PAH involves complex mechanisms: vasoconstriction, vascular remodeling, endothelial dysfunction, inflammation, oxidative stress, fibrosis, RV remodeling, cellular hypoxia, metabolic imbalance, and thrombosis. These mechanisms are mediated by several pathways, involving molecules like nitric oxide and prostacyclin. PAH diagnosis requires clinical evaluation and right heart catheterization, confirming a value of mPAP ≥ 20 mmHg at rest and often elevated pulmonary vascular resistance (PVR). Even if an early and accurate diagnosis is crucial, PAH still lacks effective biomarkers to assist in its diagnosis and prognosis. Biomarkers could contribute to arousing clinical suspicion and serve for prognosis prediction, risk stratification, and dynamic monitoring in patients with PAH. The aim of the present review is to report the main novelties on new possible biomarkers for the diagnosis, prognosis, and treatment monitoring of PAH.