Osteopontin in patients with idiopathic pulmonary hypertension.
Chest. 2010 Oct 14;
Authors: Lorenzen JM, Nickel N, Krämer R, Golpon H, Westerkamp V, Olsson KM, Haller H, Hoeper MM
ABSTRACT BACKGROUND: Osteopontin (OPN) is a pleiotropic cytokine that has been postulated to play a role in the pathogenesis of idiopathic pulmonary arterial hypertension (IPAH). OPN plasma levels may be related to disease severity and mortality in patients with PAH. METHODS: OPN plasma levels obtained during right heart catheterization were assessed by a commercially available ELISA and related to hemodynamics, exercise capacity, NT-pro-BNP, uric acid, C-reactive protein and survival in two cohorts of IPAH patients: a 4 year retrospective cohort (n=70) and a prospective cohort (n=25) followed for 3 months after initiation of therapy. Forty apparently healthy individuals served as controls. RESULTS: Baseline OPN levels were elevated in IPAH patients compared to healthy controls (50.2 ± 35.9 ng/mL vs. 23.7 ± 2.8 ng/mL, p<0.0001). In the retrospective as well as in the prospective cohort, OPN levels correlated with mean right atrial pressure and NT-pro-BNP. In the retrospective cohort OPN levels also correlated with with age (r=0.3, p=0.02), 6 minute walking distance (6mw) (r=-0.4, p=0.05) and NYHA class (r=0.4, p=0.001). Multivariate Cox analysis demonstrated that baseline OPN levels were independent predictors of mortality (p=0.02). When patients were divided according to their baseline OPN values being normal or elevated at baseline (below or above 34.5 ng/mL), proportional survival rates were 100% vs. 80% after 1 yr and 77% vs. 51% after 3 yrs, respectively. CONCLUSION: Circulating OPN predicts survival in patients with IPAH and is associated with a higher NYHA class. OPN may thus be useful as a biomarker in IPAH.
PMID: 20947652 [PubMed - as supplied by publisher]