From 2013.igem.org

The Problem

Acute coronary syndrome (ACS) refers to any group of clinical symptoms compatible with acute myocardial ischemia and includes unstable angina, non—ST-segment elevation myocardial infarction, and ST-segment elevation myocardial infarction (Kumar and Cannon, 2009). These high-risk manifestations of coronary atherosclerosis are important causes of the use of emergency medical care and hospitalization in the United States, where in 2004, approximately 200.000 people died by heart attack, and in 2009, about 1.190.000 patients were diagnosed with ACS (Acute Coronary Syndrome) (Heart Disease and Stroke Statistics--2012 Update : A Report From the American Heart Association). According to the World Health Organization report, ischemic heart disease and stroke are the leading causes of death in the world, responsible for 13.2 million deaths in 2011.

Figure 1. The 10 leading causes of death in the world on 2011 (World Health Organization, July 2013)

The high incidence of death in ACS patients is deeply related to its late diagnosis, which is usually made after the cardiac event has already occurred. It is observed in ACS that plaque formation and its development release several substances in the patient's blood that have a big potential to be explored as possible biomarkers for diagnosis of ACS. In this context, several biomarkers related to pathophysiological processes associated with acute myocardial infarction have been described, as shown in the Figure 2.

Figure 2 - Biomarkers related to various pathophysiological processes associated with acute myocardial infarction. Shortenings: C-Reactive Protein(CRP), Pregnancy-associated plasma protein A (PaPPA), Heart type Fatty Acid Binding Proteins(H-FABP), Brain Natriuretic Peptide (BNP), Atrial Natriuretic Peptide (ANP), Growth differentiation factor 15 (GDF-15), IL1-receptor-like protein (ST2) (Chan, D. and Ng L. L.)

Given the importance of this pathophysiological processes, UFMG_Brazil team chose to develop a Genetically Modified Organism able to measure blood serum concentrations of 3 specific ACS biomarkers as a potential prognostic test for this syndrome.

References:

• Kumar A., Cannon, C. P.,(2009) ”Acute Coronary Syndromes: Diagnosis and Management, Part I” Mayo Clinic Proceedings, vol 84, Issue 10, pages 917–938 Symposium on Cardiovascular Diseases.

• Danne, O. and Möckel, M. (2010). "Choline in acute coronary syndrome: an emerging biomarker with implications for the integrated assessment of plaque vulnerability." Expert Rev Mol Diagn 10(2): pages 159-171.

• Heart Disease and Stroke Statistics - 2012 Update : A Report From the American Heart Association.

• Searle J, Danne O, Müller C, Mockel M.(2011). "Biomarkers in acute coronary syndrome and percutaneous coronary intervention." Minerva Cardioangiol.

• Chan, D. and Ng L. L., “Biomarkers in acute myocardial infarction”, BMC Med. 2010; 8: 34. Published online 2010 June 7

• “The top 10 causes of death“, World Health Organization, July 2013, http://www.who.int/mediacentre/factsheets/fs310/en/index.html

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