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SCUBE 1: A novel biomarker related to platelet activation and atherothrombosis
SCUBE1 – Um novo biomarcador associado a ativação plaquetária e aterotrombose
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desenvolvimento da trombose tardia de <span class="elsevierStyleItalic">stent</span> com apresentação sob a forma de enfarte do miocárdio com elevação do segmento ST" ] ] "contieneResumen" => array:2 [ "en" => true "pt" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 992 "Ancho" => 1298 "Tamanyo" => 97089 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Comparison of SCUBE1 levels between the groups. ST: stent thrombosis; STEMI: ST-elevation myocardial infarction.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Hasan Ata Bolayır, Tarık Kıvrak, Hakan Güneş, Dursun Akaslan, Ömer Şahin, Aslı Bolayır" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Hasan Ata" "apellidos" => "Bolayır" ] 1 => array:2 [ "nombre" => "Tarık" "apellidos" => "Kıvrak" ] 2 => array:2 [ "nombre" => "Hakan" "apellidos" => "Güneş" ] 3 => array:2 [ "nombre" => "Dursun" "apellidos" => "Akaslan" ] 4 => array:2 [ "nombre" => "Ömer" "apellidos" => "Şahin" ] 5 => array:2 [ "nombre" => "Aslı" "apellidos" => "Bolayır" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S0870255117302573" "doi" => "10.1016/j.repc.2017.07.015" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255117302573?idApp=UINPBA00004E" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204918301624?idApp=UINPBA00004E" "url" => "/21742049/0000003700000005/v1_201806100418/S2174204918301624/v1_201806100418/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Editorial comment</span>" "titulo" => "SCUBE 1: A novel biomarker related to platelet activation and atherothrombosis" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "383" "paginaFinal" => "385" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "Luís Bronze" "autores" => array:1 [ 0 => array:4 [ "nombre" => "Luís" "apellidos" => "Bronze" "email" => array:1 [ 0 => "luis.bronze@gmail.com" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Hospital das Forças Armadas, Polo de Lisboa, Lisboa, Portugal" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Faculdade de Ciências da Saúde, Mestrado Integrado de Medicina, Universidade da Beira Interior, Covilhã, Portugal" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Linha de Saúde, Centro de Investigação Naval (CINAV), Marinha Portuguesa, Lisboa, Portugal" "etiqueta" => "c" "identificador" => "aff0015" ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "SCUBE1 – Um novo biomarcador associado a ativação plaquetária e aterotrombose" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">“First of all, forgive me for speaking to you seated, but the truth is that if I stand, I run the risk of collapsing with fear.” – Gabriel Garcia Márquez<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The article by Bolayır et al. on the role of SCUBE1 in the pathogenesis of late stent thrombosis presenting with ST-elevation myocardial infarction (STEMI) published in this issue of the <span class="elsevierStyleItalic">Journal</span><a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">2</span></a> sends us into the wider world of biomarkers and translational medicine, which have driven much of the research on atherothrombosis in recent years. Russell Ross's landmark 1999 work<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">3</span></a> on the inflammatory etiology of atherosclerosis opened a Pandora's box for those who search within the fine structure of the highly complex processes of atherosclerotic pathophysiology for molecules that are directly or indirectly related to the mechanisms of atherosclerosis, from their inflammatory genesis to the eventual thrombotic event. However, no molecule fully accounts for an entire process, and so each biomarker has a limited ability to represent reality.<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">4</span></a> This principle should be kept in mind and put into practice.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The study by Bolayır et al. aims to present the results for a new biomarker associated with late stent thrombosis in STEMI patients. It sets out to address two important issues. The first is the importance of early assessment of stent thrombosis, a relatively rare but serious complication that has been extensively studied,<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">5–7</span></a> especially with regard to the differences between bare-metal stents (BMS) and the newer drug-eluting stents (DES).<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">8,9</span></a> The latter are in theory less susceptible to in-stent restenosis, even in patients with significant predisposing factors, such as diabetes.<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">10</span></a> The authors’ second focus is platelet activation, which plays a crucial role in the progression of atherothrombosis. There is growing evidence of the importance of platelets in the atherosclerotic process and of their effects, ranging from the inflammation that initiates atheroma formation when they bind to leukocytes and endothelial cells, to platelet activation itself, due to plaque rupture or erosion, triggering coronary thrombosis.<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">11</span></a> As evidence of the importance of platelet activity, a large number of biomarkers are known to influence this process, which can be divided into circulating and membrane-associated molecules. These molecules have been particularly thoroughly studied in the context of acute ischemia.<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">12</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Bolayır et al. assess this issue through the potential of a novel platelet adhesion molecule, whose complex name – signal peptide-CUB (for complement proteins C1r/C1s, Uegf and Bmp1)-EGF (for epidermal growth factor)-like domain-containing protein 1 (SCUBE1) – is somewhat intimidating for cardiologists who are unfamiliar with the latest findings in basic research.<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">13</span></a> This protein is the founding member of a cell membrane-associated class of molecules known as the SCUBE family. Members of this new family have been identified in human endothelial cells and platelets.<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">14</span></a> The SCUBE1 protein is normally stored in platelet alpha granules and translocated to the surface on thrombin activation. It is also incorporated into the growing thrombus.<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">12,14</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">SCUBE1 has been proposed as a novel platelet endothelial cell adhesion molecule, since particularly high serum levels are found in atherothrombotic conditions such as acute coronary syndrome and large-vessel thrombotic stroke.<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">12</span></a> The molecule also promotes platelet-platelet interaction and is involved in platelet adhesion to the subendothelial matrix.<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">13</span></a> Moreover, deposition of SCUBE1 has been found in the subendothelial matrix of advanced atherosclerotic lesions.<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">14</span></a> SCUBE1 blockade may even be a new antithrombotic strategy.<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">15</span></a> All of the above data on this new biomarker makes it potentially attractive for the diagnosis of arterial thrombosis in medium-sized and large vessels,<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">16,17</span></a> as a marker of ischemia in acute coronary syndrome,<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">18</span></a> or even as a new therapeutic target.</p><p id="par0030" class="elsevierStylePara elsevierViewall">This potential led the authors to proceed with the clinical study presented here. Their methodology is open to criticism, since only 40 patients with documented stent thrombosis hospitalized due to STEMI were recruited, compared to a substantially larger heterogeneous control population (n=150), consisting of patients with STEMI (n=100) and no late stent thrombosis and patients who were healthy on cardiovascular assessment (n=50). The authors acknowledge that the small sample size is a limitation that could be resolved in the future by conducting a multicenter study. Another limitation is the lack of data on which stents were used in the study population (BMS vs. DES). This information would give a more solid foundation to the study's conclusions. However, the statistical analysis does not appear to have been affected by the heterogeneity of the control group, since in all cases three groups are compared, thus maintaining the different characteristics of the study groups.</p><p id="par0035" class="elsevierStylePara elsevierViewall">The discussion conveys the importance of platelet activation in acute coronary ischemia, as well as in other vascular conditions, such as ischemic stroke.<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">16</span></a> Bolayır et al. are right to stress this point, since the role of platelet adhesion markers has already been demonstrated by the importance of the CD40 ligand, elevated levels of which are associated with unstable coronary artery disease.<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">19</span></a> The authors set out to add to this knowledge in their study, in which, despite the above-mentioned limitations, they claim to have proved the relationship between late stent thrombosis and serum SCUBE1 level.</p><p id="par0040" class="elsevierStylePara elsevierViewall">For our part, we recognize that the study has limitations, but it is headed in the right direction. As in the quotation by Gabriel García Márquez, a writer known for his humility, we suggest that it is better to proceed with caution; with regard to SCUBE1 in the great ocean of biomarkers of atherothrombotic disease, it is better to speak while seated, since we could lose our way if we say too much. We believe that there is still much to be learned before this promising molecule can reach clinical practice.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0045" class="elsevierStylePara elsevierViewall">The author has no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Bronze L. SCUBE1 – Um novo biomarcador associado a ativação plaquetária e aterotrombose. Rev Port Cardiol. 2018;37:383–385.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:19 [ 0 => array:3 [ "identificador" => "bib0100" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Yo no vengo a decir un discurso" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "G. García Márquez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:4 [ "edicion" => "1st ed." 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 8 | 6 | 14 |
| 2024 October | 34 | 31 | 65 |
| 2024 September | 59 | 28 | 87 |
| 2024 August | 61 | 21 | 82 |
| 2024 July | 46 | 31 | 77 |
| 2024 June | 60 | 29 | 89 |
| 2024 May | 37 | 29 | 66 |
| 2024 April | 37 | 22 | 59 |
| 2024 March | 52 | 36 | 88 |
| 2024 February | 37 | 18 | 55 |
| 2024 January | 27 | 22 | 49 |
| 2023 December | 34 | 25 | 59 |
| 2023 November | 48 | 27 | 75 |
| 2023 October | 34 | 14 | 48 |
| 2023 September | 21 | 17 | 38 |
| 2023 August | 36 | 17 | 53 |
| 2023 July | 66 | 7 | 73 |
| 2023 June | 52 | 9 | 61 |
| 2023 May | 67 | 25 | 92 |
| 2023 April | 50 | 6 | 56 |
| 2023 March | 72 | 24 | 96 |
| 2023 February | 32 | 23 | 55 |
| 2023 January | 27 | 19 | 46 |
| 2022 December | 49 | 26 | 75 |
| 2022 November | 63 | 23 | 86 |
| 2022 October | 36 | 38 | 74 |
| 2022 September | 30 | 37 | 67 |
| 2022 August | 26 | 35 | 61 |
| 2022 July | 45 | 51 | 96 |
| 2022 June | 34 | 25 | 59 |
| 2022 May | 34 | 27 | 61 |
| 2022 April | 33 | 36 | 69 |
| 2022 March | 37 | 44 | 81 |
| 2022 February | 29 | 28 | 57 |
| 2022 January | 27 | 27 | 54 |
| 2021 December | 23 | 26 | 49 |
| 2021 November | 22 | 38 | 60 |
| 2021 October | 55 | 43 | 98 |
| 2021 September | 27 | 32 | 59 |
| 2021 August | 24 | 29 | 53 |
| 2021 July | 11 | 26 | 37 |
| 2021 June | 23 | 25 | 48 |
| 2021 May | 31 | 41 | 72 |
| 2021 April | 35 | 73 | 108 |
| 2021 March | 40 | 27 | 67 |
| 2021 February | 59 | 16 | 75 |
| 2021 January | 28 | 20 | 48 |
| 2020 December | 36 | 9 | 45 |
| 2020 November | 25 | 19 | 44 |
| 2020 October | 21 | 24 | 45 |
| 2020 September | 59 | 14 | 73 |
| 2020 August | 13 | 7 | 20 |
| 2020 July | 52 | 12 | 64 |
| 2020 June | 50 | 9 | 59 |
| 2020 May | 43 | 10 | 53 |
| 2020 April | 35 | 8 | 43 |
| 2020 March | 39 | 13 | 52 |
| 2020 February | 50 | 18 | 68 |
| 2020 January | 35 | 6 | 41 |
| 2019 December | 46 | 9 | 55 |
| 2019 November | 22 | 6 | 28 |
| 2019 October | 33 | 6 | 39 |
| 2019 September | 33 | 11 | 44 |
| 2019 August | 27 | 6 | 33 |
| 2019 July | 43 | 9 | 52 |
| 2019 June | 32 | 19 | 51 |
| 2019 May | 34 | 12 | 46 |
| 2019 April | 29 | 17 | 46 |
| 2019 March | 18 | 12 | 30 |
| 2019 February | 36 | 13 | 49 |
| 2019 January | 64 | 4 | 68 |
| 2018 December | 47 | 17 | 64 |
| 2018 November | 72 | 20 | 92 |
| 2018 October | 87 | 41 | 128 |
| 2018 September | 44 | 16 | 60 |
| 2018 August | 35 | 12 | 47 |
| 2018 July | 23 | 11 | 34 |
| 2018 June | 90 | 34 | 124 |
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