FAKULTET VETERINARSKE MEDICINE UNIVERZITET U BEOGRADU

Klinika patologija i t!apija "ali# $i%otinja i konja

SR&ANI BIOMARKERI U VETERINARSKO' MEDICINI SA OSVRTOM NA
N'I(OVU )RIMENU KOD KON'A
*S"ina!+ki !a,-
MENTOR. STUDENT.
)!o/0,! D!agi1a T!ailo%i2 Nina Sko!3pan 455678
BEOGRAD9 45:; go,0
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4
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kao "a!k!i >a +!ana o1t2nja0 S!ani ?io"a!k!i + ,/ini13 kao klinikoHla?o!ato!ij+ki
"a!k!i koji + ko!i+t >a ,tkIij3 ak3tnog in/a!kta "ioka!,a @AIMA ili "anji# +!ani#
o1t2nja0 Naj%2i ?!oj ?io"a!k!a +3 +!ani p!otini0 Oni + "J3+o?no !a>lik3j3 po
"+t3 g, + nala> 3 "ioIit39 k!tanj3 nakon o1t2nja "ioIita i ?!>ini 3klanjanja i>
Ii!k3laIij0U #3"anoj ",iIini9 j,na o, naj%a$niji# p!i"na +!ani# ?io"a!k!a j
,ijagno+tika ak3tnog in/a!kta "ioka!,a ko, ?ol+nika +a ?olo" 3 g!3,i"a @C#!i+tn+on
t al09:EEBA0 Mnogi o%i p!otini takoJ ig!aj3 i %a$n3 3log3 3 p!oIni p!ogno> ko,
+!ani# ?ol+nika9 a ko"?inaIija poj,inani# ?io"a!k!a 2 %!o%atno ?iti o, ko!i+ti 3
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?ol+nika0
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?io"a!k!a i p!ogno> +!ani# o?oljnja0 N,a%na lit!at3!a opi+3j ko!i+t o%i# ppti,a
>a !a>liko%anj +!ani# o, nH+!ani# o?oljnja ko, "ali# $i%otinja@T!aI#+l t al0945::A0
O%aj !a, !a>"at!a naj%a$nij +!an ?io"a!k! i nji#o%3 3pot!?3 3 %t!ini 9 a po+?no
3 konj+koj ",iIini0
Ta?la :0 +3"i!a gla%n +!an ?io"a!k! koji + ko!i+t 3 #3"anoj i %t!ina!+koj
",iIini0 T!oponin i nat!i3!tini ppti,i + 3gla%no" ko!i+t 3 +%ako,n%noj p!ak+i9 ali
takoJ i al,o+t!on9 #o!"on RHAHA +i+t"a + "o$ "!iti ,a + p!oIni +tanj +!Ia0
Ta?la :0
MARKERI MIOCITNOG STRESA BN)
NTHp!oBN)
AN)
NTHp!oAN)
MARKERI MIOCITNOG OCTEDEN'A T!oponin T
T!oponin I
K!atin kina>a
Laktat ,#i,!ogna>a
NEURO(ORMONI Al,o+t!on
No!pin/!in
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MARKERI REMODELIRAN'A Mtalop!otina>a "at!ik+a
Tki%ni in#i?ito!i "at!ik+ "talop!otina>
Kolagn p!oppti,i
MARKERI INFLAMACI'E CR) @ C !akti%ni p!otinA
ILH:9 ILH8 i ILH:E
TNFHal/a
INDIREKTNI MARKERI
OKSIDATIVNOG STRESA
Ok+i,o%ani LDL
Mijlop!ok+i,a>a
NATRIURETINI PEPTIDI, MARKERI MIOCITNOG STRESA
Fiziologija i strutura
Ko, +i+a!a9 !a>lik3j"o = gla%na nat!i3!tika ppti,a. at!ijalni nat!i3!tini ppti,
@AN)A9 "o$,ani nat!i3!tini ppti, @BN)A i CHtip nat!i3!tinog ppti,a @CN)A0
Mo$,ani nat!i3!tini ppti,9 BN) @brain natriuretic peptidA9 j #o!"on i>olo%an i>
+%inj+kog "o$,anog tki%a0 Njgo% ?iolo1ki /kat j +lian /kt3 at!ijalnog
nat!i3!tinog ppti,a @AN) H atrial natriuretic peptidA0 Ugla%no" j +"1tn 3
"ioka!,ij3"3 +!ani# ko"o!a0 Ni%o BN)Ha 3 k!%i j %2i 3 +tanji"a #ip!%ol"ij kao
1to j to ko, kong+ti%n +!an in+3/iIijnIij i #ip!tn>ij0
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tno+ti 3 o!gani>"39 k!%ni p!iti+ak i lkt!olitiki ?alan+0 Oni i"aj3 akti%no+t 3
Int!alno" i p!i/!no" +i+t"30 )!%o j otk!i%n AN)9 a n1to ka+nij i BN) 3
+%inj+ko" "o>g30 Iako + +t%a!a 3 "o>g39 naj%2 %!,no+ti BN) 3 Ii!k3laIiji poti3 i>
+!ani# ko"o!a0 O+tali N) +3 nat!i3!tini ppti, CHtipa i 3!o,ilatin0 O%a ,%a #o!"ona +
n +intti13 3 "ioka!,39 ali + o+lo?aJaj3 >aj,no +a AN)Ho" i BN)Ho" ko, paIijnata
+a #ip!%ol"ijo"9 #ip!tn>ijo" i #iponat!ij"ijo"0

AN) i BN) + o+lo?aJaj3 kao o,go%o! na p!tko"o!+ko i7ili ko"o!+ko !a+t>anj 3
+tanj3 #ip!%ol"ij0 )o!a+t N) + ja%lja 3 +%i" ?ol+ti"a +a #ip!%ol"ijo" 3klj33j32i
?ol+ti ?3?!ga9 jt! i nka n,ok!ina o?oljnja @K31ingo%a ?ol+t9 p!i"a!ni
#ip!al,o+t!oni>a"A0 S% 3>%1i9 3loga N) j ,a !,3k3j p!o,3kIij3 !nina i
al,o+t!ona i tako o"og32i ?olj3 glo"!3la!n3 /ilt!aIij3 i i>l3i%anj 3!ina0

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BN) + +intti1 3 "ioIit3 kao p!p!oH#o!"on9 >ati" + p!%o,i 3 p!oBN) i poto"
i>?aI3j 3 Ii!k3laIij30 Dj+t%o" p!ota> + i> p!oBN)Ha o+lo?aJa NTp!oBN) /!ag"nt
i BN) koji i"a /i>iolo1k3 akti%no+t0 Eli"inaIija o% ,% /o!" + o,%ija p!ko ?3?!ga0
BN) + !a>g!aJ3j ,j+t%o" n3t!aln n,oppti,a>9 a !nalna li"inaIija j !Ipto!+ki
po+!,o%ana0 Za !a>lik3 o, BN)Ha9 NTHp!oBN) /!ag"nt + n i>l33j "#ani>"o"
p!ko !Ipto!a9 ali i"a ,o"inantn3 ?3?!$n3 li"inaIij30

BN) i"a %i1+t!3k3 +!an3 /3nkIij39 a o+lo?aJa + kao !g3lato!ni #o!"on 3 o,go%o!3
na !a>liit +!an napo!9 na!oito p!i +!ano" !a+t>anj30 )!"a to"9 #o!"on j
o+tlji% "a!k! >a p!o"n 3 /i>iologiji ko"o!0 KonInt!aIija Ii!k3li132g BN)Ha >a%i+i
o, pola i +ta!o+ti9 a po%2an j ko, #!oninog +!anog o?oljnja +!a>"!no njgo%oj
o>?iljno+ti0 Dana+ + >na ,a j "!nj BN)Ha ko!i+no >a i,nti/ikaIij3 paIijnata +a
+!,nj o>?iljno" kong+ti%no" +!ano" in+3/iIijnIijo"0

St!3kt3!a AN) "olk3la j ,o?!o +a3%ana i po+toji :55 K #o"ologija i>"J3 lj3,+kog i
konj+kog AN) @ Ta?la 4A9 1to ,alj i"pliIi!a ,a + lj3,+ki t+to%i "og3 ko!i+titi >a
"!nj konInt!aIij AN) 3 k!%i konja @RiI#t! t al09 :EEB A0

U po!Jnj3 +a AN)9 BH tipa ppti,i +3 gnt+ki %!lo %a!ija?ilni i>"J3 %!+ta @Taki t
al0945::A @Ta?la 4A0 )!"a to" #3"ani t+t + n "o> ko!i+titi 3 %t!ina!+koj p!ak+i0
)o+toj +pIi/ini t+to%i >a "al $i%otinj @Ca!,iopt p!oBN)9 IDELL Vt M, La? A0
MJ3ti"9 t+t >a konj jo1 3%k nij ,o+t3pan0 )o1to po+toji +lino+t i>"J3 konj+kog i
+%inj+kog BN) @E5K #o"ologijaA 9 t+t >a +%inj ?i "ogao ,a + ko!i+ti >a "!nj
konInt!aIij BN) 3 k!%i ko, konja @ Ta?la 4 A0
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Ta!"la #$ Por"%"&j" a'i&ois"li&s" s"("&)" atrijal&og i 'o*+a&og &atriur"ti,&og
-"-ti+a o+ ,o("a , o&ja, s(i&j" , -sa i 'a,"$ .a razliu o+ ANP, /NP j" (rlo
razli,it iz'"%u (rsta$ Ko&jsi /0ti- &atriur"ti,&og -"-ti+a i'a ("1" sli,&osti sa
s(i&jsi' o!lio' &"go sa 2u'a&i' o!lio' /NP 3 'ol"ula$ Cr("&o o!"l"*"&"
a'i&ois"li&" su s-")i4i,&" za o+r"%"&" (rst" 5Ri)2t"r "t al$, 67789 Go"tz", #::;9
Ta"i "t al$, #:66<$
Atrijal&i &atriur"ti,&i -"-ti+
(3" S L R R S S C F G G R M D R I G A M S G L G C N S F R
EN S L R R S S C F G G R M D R I G A M S G L G C N S F R
S3 S L R R S S C F G G R M D R I G A M S G L G C N S F R
Can S L R R S S C F G G R M D R I G A M S G L G C N S F R
Fl S L R R S S C F G G R M D R I G A M S G L G C N S F R
Mo*+a&i &atriur"ti,&i -"-ti+
(3" S ) K M V M G S G C F G R K M D R I S S S S G L G C K
EN S ) K M M R N S G C F G R R L D R I G S F S G L G C N
S3 S ) K T M R D S G C F G R R L D R I G S L S G L G C N
Can S ) K M M ( K S G C F G R R L D R I G S L S G L G C N
F S S K M M R D S R C F G R R L D R I G S L S G L G C N
V L R L R
V L R R O
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8
U-otr"!a &atriur"ti,i2 -"-ti+a u 'aloj -rasi

Ka!akt!i+tik ko"!Iijalni# t+to%a + !a>lik3j3 po +tan,a!,i"a "!nja i 3pot!?i
antitla0 Ko!i+t + !a>liita antitla koja p!po>naj3 !a>liit pitop BN)Ha i NTH
p!oBN)Ha0 T+to%i >a BN) +3 "anj analitik +ta?ilno+ti na +o?noj t"p!at3!i 3 p!io,
o, ; +ata >a !a>lik3 o, NTHp!oBN) t+to%a ija j +ta?ilno+t i ,o 64 +ata 3 i+ti" 3+lo%i"a0
TakoJ9 +ta?ilno+t i"3no!akIij >a%i+i o, toga ,a li j 3>o!ak k!%i 3 +taklnoj ili
pla+tinoj p!3%ti0 )oka>ano j ,a j >a =5HB5K "anja +ta?ilno+t 3 +takl3 nakon ;HB +ati0
)o+toji nkoliko p!aktini# !a>loga >a1to + o,!J3j3 i p!at BN) i NTHp!oBN) 3
+!3"39 pla>"i ili p3noj k!%i0 )!%o9 !/!ntni int!%ali + !a>lik3j3 >a%i+no o, ko!i12ni#
t+to%a i p!i!o, !/!ntnog 3>o!ka9 a ,!3go9 ?!ojni kliniki /akto!i 3ti3 na
konInt!aIij3 BN)Ha i NTHp!oBN)Ha kao 1to +3 +ta!o+t9 pol9 !nalna /3nkIija i +lino0
O,!Ji%anj pla>"at+kog BN)Ha ili NTHp!oBN)Ha t!?a ,a o"og32i.
pot%!,3 ,ijagno> kong+ti%n +!an in+3/iIijnIij ko, paIijnata +a
+i"pto"i"a +lini" #!oninoj op+t!3kti%noj ?ol+ti pl32a
nap!,o%anj 3 ,ijagno+tikoj tano+ti >a ,tkIij3 kong+ti%n +!an
in+3/iIijnIij
3p!a%ljanj kong+ti%no" +!ano" in+3/iIijnIijo" ka,a +3 p!onaJn %!,no+ti
nat!i3!tinog ppti,a no!"aln0

Naj%a$nij j >nati ,a +a" po +?i BN) nij ,o%oljan 3 !a>"at!anj3 kong+ti%n +!an
in+3/iIijnIij @KSIA i ,a + 3 o?>i! "o!aj3 3>ti klinika +lika i ,!3gi /akto!i pop3t
go,ina i pola paIijnta0 St3,ij poka>3j3 ,a BN) nij +t!iktno +pIi/ian >a KSI0 Do
po%2anja "o$ ,o2i ko, ,!3gi# po!"2aja n3>!oko%ani# +!ano" in+3/iIijnIijo"
kao 1to +3 #ip!t!o/ija l% ko"o!9 in/la"ato!no +!ano o?oljnj9 a!t!ij+ka i
p3l"onalna #ip!tn>ija9 ak3tno i #!onino ?3?!$no o?oljnj9 Ii!o>a jt!9 nki
n,ok!ini po!"2aji i ,!0
6
5Mogu1a< u-otr"!a &atriur"ti,&i2 -"-ti+a u ("t"ri&arsoj -rasi o+ o&ja
Kao 1to j %2 !no 9 n po+toji po+?an konj+ki BN) ili NTHp!o BN) t+t na
!a+polaganj30 Stoga +3 konj+k ?io"a!k! +t3,ij og!anin na "!nj at!ijalnog
nat!i3!tinog ppti,a +a #3"ani" t+to%i"a0 G#ln@4556A i T!aI#+l@45::A +3 3t%!,ili
no!"aln %!,no+ti >a konj @:G98H489; pg7"l i 694H=; pg6"lA ko!i+t2i ,% !a>liita
!a,ioi"3nolo1ka t+ta @ RIA S45:: i RIA RKH55GH58 AN)Hal/aA i na1li +3 po>iti%n3
ko!laIij3 i>"J3 konInt!aIij AN) i 3%2anja l% p!tko"o! +!Ia0
TROPONIN, MARKER MIOCITNOG O=TE>EN?A
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+"1tn 3 "io/i?!ila"a @E;HE6KA9 a n1to "alo ga i"a 3 Iitopla>"i @=H8KA0 T!oponin j
p!otin+ki ko"plk+ koga in t!i +3?j,iniI9 t!oponin C9 I i T0 S3?j,iniIa C j Ca4PH
%>3j32a ko"ponnta9 I j in#i?ito!na9a T j t!opo"io>inH%>3j32a ko"ponnta0 O%
+3?j,iniI + "og3 na2i 3 %i1 i>o/o!"i0 Sa"o ,% %lik i>o/o!" t!oponina C +3
p!onaJn 3 #3"ano" +!I3 i +kltni" "i1i2i"a0 On +3 ka!akt!i+tin >a +po!3 i ?!>3
+kltn3 kont!akIij30 S!ana i>o/o!"a j i,ntina +a i>o/o!"o" +po! +kltnH"i1i2n
kont!akIij0 I>o/o!" T i I +3 +!ano +pIi/in0 T!oponin I i T i"aj3 !a>liit3
a"inoki+lin+k3 +k%nI3 i ko,i!ani +3 o, +t!an !a>liiti# gna0 O%o i" ,aj j,in+t%n3
+!an3 +pIi/ino+t0 Ek+p!+ija ITnT i>o/o!" j 3ona i ko, paIijnata +a "i1i2no"
,i+t!o/ijo"9 poli"io>iti+o"9 ,!"ato"io>iti+o" i +l0 )!"a to"9 nop#o,no j %o,iti
!a3na o i>?o!3 o,go%a!aj32g pa!a antitla >a analitik t+to%0
)!%o +3 !a>%ijni !a,ioi"3not+to%i >a "!nj ITnI koji +3 ko!i+tili poliklon+ka antiH
ITnI antitla0 Iako poka>3j n>natn3 +pIi/ino+t @4KA p!"a +kltno" TnI9 o%aj t+t i
,alj i"a o,lin3 klinik3 +pIi/ino+t ko, po%!, +!anog "i1i2a0 O%aj t+t nij
a3to"ati>o%an i n"a ko"!Iijaln3 3pot!?30 )!%i "onoklon+ki ELISA @n>Q"Hlink,
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i""3no+o!?nt a++aQA t+t +9 takoJ9 >a+ni%ao na !akIiji +a antiHITnI antitlo"0 On j
poka>i%ao >natno "anj3 3nak!+n3 !akIij3 +a +kltni" TnI o, +%ga 59:K0 Z?og ,3$in
i>%oJnja9 ni o%aj t+t + n ko!i+ti 3 klinikoj p!ak+i0 Dana+9 >a o,!Ji%anj t!oponina I
+ ko!i+ti >natno ?!$i R,%o+t!3ki +n,%iS i"3not+t @ELISAA0 O%aj t+t ko!i+ti
poliklon+ka antitla koja p!po>naj3 !a>liit polippti,n +g"nt ka!,ijalnog
t!oponina I0 Oki%an no!"aln %!,no+ti t!oponina I n t!?a ,a ?3,3 %i1 o, 59G ng7L0
V!,no+ti i>na, o%9 "og3 ?iti in,ikaIija >a AIM0 MJ3ti"9 "nogo j %a$nij p!atiti
%!,no+ti t!oponina I 3 %!"n+ki" int!%ali"a nakon p!%og ka!,ijalnog ?ola9 pa 3>
o+tal klinik i la?o!ato!ij+k pa!a"t! int!p!ti!ati !>3ltat0 ITnI j p!i+3tan 3
Ii!k3laIiji 3 t!i /o!". +lo?o,an9 %>an 3 ?ina!ni ko"plk+ @ITnIHITnCA i %>an kao
t!o+t!3ki ko"plk+ @ITnTH ITnIHITnCA tako ,a !a>liiti t+to%i ,aj3 !a>liit !>3ltat0
Z?og po+tojanja o%i# /o!"i9 po!Jnj +a ap+ol3tni" konInt!aIija"a ITnI9 ,o?ijni" 3
kliniki" +t3,ija"a9 + n "og3 i n ?i t!?alo i>%o,iti0
Ako j "og329 +%aka la?o!ato!ija ?i t!?alo ,a o,!,i op+g !/!ntni# %!,no+ti >a
ko!i12ni t+t 3 o,no+3 na !/!ntni ili ,a %ali,aIij3 +%og t+ta ?a>i!a na po,aIi"a i>
akt3ln lit!at3!0 Tako,j9 t!?a 3t%!,iti p!i#%atlji%o o,+t3panj p!ko ko/iIijnta
%a!ijaIij @CV H Io//iIint o/ %a!iationA >a ,ati t+t0 Na$alo+t9 %2ina la?o!ato!ija n
!a+pola$ !+3!+i"a >a i>%oJnj o%ak%i# i+piti%anja %2 %!,no+ti p!i#%ata i> akt3ln
lit!at3! >a ,ato po,n?lj0
)o+toji nkoliko !a>loga >a1to + +!ani t!oponin o,!J3j kao ?io"a!k!0 )!%o9 ITnI i
ITnT + !ano i ?!>o o+lo?aJaj3 3 Ii!k3laIij3 nakon AIM9 +lino CKH49 a o+taj3 po%2ani
i>na, !/!ntni# g!aniIa na!,ni# 4H8 +ati0 )otno po%2anj poti o, Iitopla>"at+k
/!akIij t!oponina @=H8KA >a !a>lik3 o, CKH4 koji j i+klj3i%o Iito>olni n>i"0 D!3go9
ITnI i ITnT "og3 o+tati %i+oki ;H:; ,ana nakon AIM @Slika 60A0 O%o + o?ja1nja%a ti"
,a j E;HE6K /!akIij t!oponina %>ano >a "io/i?!il0 Konano9 o% /o!" t!oponina
"og3 ,a li"ini13 lo13 p!oIn3 ,a j ! o AIM ko, paIijnata ija j CKHMB po%2ana
>?og po%!, +kltnog "ii2a0
U-otr"!a sr,a&og tro-o&i&a u 'aloj -rasi
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ITnI anali>ato!0 )o%2anj ITnI j >a?l$no ko, pa+a +a ka!,io"iopatijo"9
+3?%al%3la!no" +tno>o" ao!t9 ?ol+ti "it!alni# >ali+taka i +!ani# 3>!oka !+pi!ato!nog
,i+t!+a@ OQa"a an, Si++on9 455;T Linklat! t al09 4556T Baki!l an, G3n+9 455EA0
Slin +t3,ij ko, "aaka +3 poka>al po%2anj ITnI ko, "aaka +a +!ano"
,i+pnjo"@ (!n,on t al09 455BA0 U po!Jnj3 +a ITnI9 +!ani t!oponin T j "anj
o+tlji% >a ,ijagno>3 +!anog o?oljnja ko, pa+a0 Taan !a>log to" j jo1 3%k npo>nat9
ali Linklat! t al0@4556A j +3g!i+ao ,a j !a>log 1to "anji "olk3l ITnI @"olk3l+k
"a+ 45 555 DaA "o$ ,o%+ti ,o lak1g otp31tanja o%og "olk3la i> t!opo"io>in+kog
ko"lk+a ngo %2i ITnT p!otin @ "olk3l+k "a+ ;5 555 DaA0
U-otr"!a tro-o&i&a u ("t"ri&arsoj -rasi o+ o&ja
T!n3tno +!ani t!oponin I j j,ini +!ani ?io"a!k! koji + 3+p1+no ko!i+ti 3 konj+koj
%t!ina!+koj p!ak+i >a p!oIn3 o1t2nja "ioka!,a0 R/!ntn %!,no+ti +3
3+po+ta%ljn +a !a>liiti" t+to%i"a9 i n,a%no j 3t%!Jn pol3>i%ot >a konj+ki ITnI0
T!?a i"ati 3 %i,3 ,a !/!ntn %!,no+ti "og3 ,a %a!i!aj3 "J3 !a>liiti" t+to%i"a i
la?o!ato!ija"a0 Dakl9 3>o!ak k!%i o, konja +a +!ani" p!o?l"i"a t!?a 3%k 3po!,iti
+a +pIi/ini" !/!ntni" %!,no+ti"a t+ta0
Kako j pol3$i%ot t!oponina ko, konja 59;6# 9 +talna %i+oka %!,no+t ITnI j 3 %>i +a
o1t2nj" "ioka!,a @K!a3+ t al0945::A0 O%aj k!atak pol3$i%ot takoJ 3ti na
opti"alno %!" >a o,!Ji%anj konInt!aIij ITnI0 U to!iji9 opti"alno %!" >a
3>o!ko%anj j :H4 # po+l +3"nj na "ak+i"alno po%2anj ITnI0 Slino AN)9 %$?a
!>3lti!a po%2anj" ITnI @No+tll an, (ag+t!o"9 455BA0 N +a"o %!" 3>o!ko%anja9
ngo i !3ko%anj 3>o!Ii"a "o$ ,a 3ti na !>3ltat0
Na+3p!ot #3"anoj ",iIini9 +!ani t!oponin T ko, konja i"a ni$3 ,ijagno+tik3
%!,no+t0 Znaajno %2a ITnT %!,no+t j >a?l$na ko, konja +a t1ko"
in+3/iIijnIijo" >ali+taka i ,ilataIijo" +!Ia0 N tako >naajno po%2anj ?i "oglo ,a +
:5
>a?l$i ko, konja +a 3"!no" %al%3la!no" in+3/iIijnIijo" ali ?> +!an ,ilataIij0
Vi+oka %!,no+t ITnT j takoJ p!onaJna ko, konja +a ?3?!$no" in+3/iIijnIijo"0
Iako j 3 pitanj3 j,an >a?l$n +l3aj nagla1a%a + %a$no+t ?3?!$nog kli!n+a ka,a +
t3"ai po!a+t ITnT0
A@DOSTERON
Fiziologija i strutura
No!"alna /i>iologija RHAHA +i+t"a j p!ika>ana na SliIi :0 O+no%na /3nkIija "3 j
p!a2nj p!otoka k!%i 9 p!iti+ka 9 ki+onika i konInt!aIij nat!ij3"a @M3no> t al09 45:5A0
Kao o,go%o! na +"anjnj j,nog o, o%i# pa!a"ta!a9 !nin + o+lo?aJa i>
j3k+taglo"!3la!nog apa!ata 3 ?3?!g39 i t!an+/o!"i1 Ii!k3li132i angiotn>in 3 +la?o
akti%an angiotn>in I0 Nakon toga 9 po, 3tiIaj" angiotn>inH kon%!t3j32g n>i"a9
,ola>i ,o Ipanja angiotn>in I i na+taj ?iolo1ki akti%an angiotn>in II0 O%o i"a !a>liit
/kt9 3klj33j32i i l3nj al,o+t!ona 1to po%2a%a p!otok k!%i i k!%ni p!iti+ak tako 1to
+ti"3li1 !+o!pIij3 nat!ij3"a i %a>okon+t!ikIij3 @U?!9455:A0
Slika:0
::
Al+ost"ro& o+ o&ja sa sr,a&i' -ro!l"'i'a
Al,o+t!on + o+lo?aJa ko, konja +a +!ani" p!o?l"i"a0 U +l3aj3 +!an
in+3/iIijnIij9 +"anjn a!t!ij+kog p!iti+ka akti%i!a !ninHangiotn>inHal,o+t!on +i+t"9
koji po%2a%a konIntaIij3 al,o+t!ona0 U o,go%o!3 na o+lo?aJanj al,o+t!ona ,ola>i
,o po%2anog >a,!$a%anja %o, 9 >?og o,!$a%anjap!otoka k!%i 0 Na$alo+t 9 to po%2anj
%ol3"n k!%i ,o,atno pogo!1a%a %2 +"anjn3 %nt!ik3la!n3 /3nkIij3 +!Ia@"3no> t
al0945:5A0
V>a i>"J3 konInt!aIij al,o+t!ona i +!anog o?oljnja j %2 p!i"2na ko, lj3,i i
pa+a0 Sa"o j,na +t3,ija j i>%,na na konji"a +a +!ani" o?oljnj"9 3 kojoj j
p!i"2na >naajna !a>lika 3 konInt!aIiji al,o+t!ona >,!a%i# konja i konja +a
#ip!t!o/ijo" l%og +!Ia@G#ln t al09455BA0
:4
)o!, ka!,ijalni# o?oljnja 9 "nogi nHka!,ijalni /akto!i9 kao 1to +3 3no+ nat!ij3"a9
%$?a i ?iolo1ki !ita" 3ti3 na konInt!aIij3 al,o+t!ona0 Ko, lj3,i 9 +3 3t%!Jn
"ak+i"aln i "ini"aln %!,no+ti al,o+t!ona oko 5B.55 3j3t!3 i 4# po+l pono2i0 Tak%a
,n%na %a!ijaIija na%,na j i 3 +t3,iji ko, konja po 'an++onH3 i Da#l?o!nH3 @:EEEA0
MJ3ti" naj%2 %!,no+ti +3 p!ija%lji%ali toko" %!i i no2i0 Lj3,+ki i konj+ki
al,o+t!on j i,ntian 9 +toga #3"ani !a,ioHi"3nolo1ki t+to%i "og3 ,a + ko!i+t >a
"!nj konIntaIij al,o+t!ona ko, konja @(a!!i+9 :EE=A0 )o!, %!"na 3>o!ko%anja9
3>o!ko" t!?a p!a%ilno !3ko%ati i +kla,i1titi0 Al,o+t!on 3 pla>"i i 3>o!Ii +!3"a +3
+ta?ilni :45# na ;C50
KREATIN KINA.A
K!atin kina>a @CKA j n>i" nop#o,an >a "i1i2n3 kont!akIij30 Ona katali>3j !akIij3
p!%oJnja k!atina 3 k!atinH/o+/at 3> po"o2 AT)Ha0 O%aj n>i" + 3 o!gani>"3 nala>i
3 +kltni" "i1i2i"a9 "o>g3 i +!ano" "i1i230 )o+toji 3 o?lik3 ,i"!a koga in
ko"?inaIij "ono"!a @MHi> "i1i2a9 BHi> "o>gaA0 Elkt!o/o!>o" na aga!o>i i Il3lo>aH
aItat3 i,nti/iko%ana +3 t!i Iito+olna @CKH=9 CKH49 CKH:A i j,an "ito#on,!ijalni
i>on>i" @CKHMtA0 CKH= @CKHMMA j ,o"inantan i 3 +kltni" i 3 +!ano" "i1i23 9
,ok j CKH4 @CKHMBA %i1 +pIi/ian >a "ioka!,0 Ko, >,!a%i# j,inki CKH: @CKHBBA
+ n nala>i 3 +!3"30 U+l, po%!, "o>ga9 kanI!a p!o+tat9 ?3?!ga ili kanI!a pl32a9
CKHBB + poja%lj3j 3 +!3"3 i njgo%a lkt!o/o!t+ka ?!>ina j naj%2a0 U +!3"3
>,!a%i# o+o?a i"a EGK CKHMM9 a o+tatak ini CKHMB0 I+t!a$i%anj" j 3t%!Jno ,a
po+toji ?a! t!i i>o/o!" CKHMM i naj"anj ti!i i>o/o!" CKHMB Tki%na /o!"a CKH
MM + o>naIa%a CKHMM=0 Ka,a + o%aj n>i" o+lo?o,i 3 Ii!k3laIij3 ,j+t%o"
:=
ka!?ok+ippti,a>a !a>la$ + na p!oi>%o, CKHMM4 i CKMM:0 Slino + ,1a%a i +a
CKHMB i>on>i"o"0 S%aka o%a i>o/o!"a i"a !a>liito pol3%!" li"inaIij i to CKH
MM: * CKHMM4 * CKHMM=9 a CKHMB: * CKHMB40 No!"alni +kltni "i1i2i9 3
>a%i+no+ti o, lokaIij9 +a,!$ jako "alo CKHMB @"anj o, 4KA0 U+l, o>?iljni# po%!,a
"i1i2a ili #i!3!1k int!%nIij ni%o CKMB "o$ >naajno ,a po!a+t0 Stalno po%2anj
CKHMB 3 +!3"3 + +!2 ko, "i1i2ni# ?ol+ti @"3+k3la!na ,i+t!o/ija9 poli"io>iti+A9 3
k!ajnj" +ta,ij3"3 !nalni# ?ol+ti ili p!i t1ko" /i>iko" napo!30
Ni%o CKH4 + "!i na !a>liit nain0 Dana+ + naj%i1 3pot!?lja%aj3 i"3not+to%i koji
ko!i+t antiHCKH4 antitla0 )o+l,nji# go,ina o%i t+to%i +3 p!ilino 3nap!Jni 3 +"i+l3
analitik i klinik o+tlji%o+ti i +pIi/ino+ti 3 o,no+3 na !anij ko!i12n
i"3noin#i?iIij3 i i"3nop!IipitaIij30 Sa,a t+to%i "og3.
V ,a "! CKH4 ,i!ktno i ,a o?>?, %i1+t!3ka "!nja
V lak1 + a3to"ati>3j3
V ?!$ + i>%o, @,o =5 "inA
V n"a int!/!nIij ,!3gi# p!otina
V "og3 ,a + o,!J3j3 3 ?ilo koj ,o?a ,ana
O% o+o?in o"og32a%aj3 la?o!ato!ija"a k%alittniji +!%i+ t+t 3+l3g 4; a+a na ,an9
+,a" ,ana 3 n,lji0 S%i t+to%i poka>3j3 ,tkIioni li"it oko : Wg7L9 a analitiki
po+t3pIi9 lina!no+t i kono"ino+t "og3 ?iti !a>liiti o, t+ta ,o t+ta0 Dijagno+tik
I3tHo// %!,no+ti + !a>lik3j3 i>"J3 t+to%a >?og n,o+tatka CKH 4 +tan,a!,a "J3
p!oi>%oJai"a0 Dana+ + !tko !3tin+ki o,!J3j3 i>o/o!" iako po+toji t#nologija koja
o"og32a%a !a>,%ajanj i k%anti/ikaIij3 !a>liiti# CKH4 i>o/o!"i0 Ona 3klj33j
i>olkt!ino /ok3+i!anj9 #!o"atog!a/ij39 i"3no?lot9 ()LC i lkt!o/o!>30 Naj%2i
p!o?l" j 3 ,3$ini o%ak%i# t+to%a9 n,o+tatk3 o+tlji%o+ti ko, %o"a ni+ki# CK
%!,no+ti i >?og n"og32no+ti ,a + lako inko!po!i!aj3 3 klinikola?o!ato!ij+ki +!%i+
toko" 4; a+a0
Iako j "!nj 3 +!3"3 3 %likoj "!i >a"njno t!oponino" I i T9 CKH4 pa!a"ta! + i
,alj ko!i+ti 3 la?o!ato!ija"a >a ,ijagno+tik3 AIM i p!po!33j + kao p!i#%atlji%a
alt!nati%a +!ano" t!oponin30 )!io!itt "!nja +!an nk!o> i"aj3 "a!k!i +l,2i"
:;
!,o". +!ani t!oponin * CKHMB @koliinaA * CKHMB @akti%no+tA * CK@3k3pnaA0 Na
SliIi :50 j p!ika>an o,no+ o+tlji%o+ti !a>liiti# "a!k!a 3 o,no+3 na %!"0 G!a/ik
poka>3j kla+ian p!i"! ni%oa "a!k!a nakon AIM0 Znaajan po!a+t CKH4 + %i,i %2
nakon ;H8 +ati o, AIM i ,alj !a+t p!la>2i !/!ntn g!aniI0 Ni%o pika j9 otp!ilik9 3
4;0 +at30 )o+l toga9 %!,no+t CKH4 opa,a i po%!atak na !/!ntni ni%o + ok3j nakon
;BH 64 +ata0 )ol3%!" li"inaIij CKH4 j nakon :5H:4 +ati0 Klinik +t3,ij9 po!,2i
+ +a ?!ojni" t+to%i"a n>i"+k akti%no+ti9 poka>3j3 ,a !anija "!nja koliin CKH4
"og3 ,a ,tkt3j3 a?no!"alini ni%o k!atin kina> 3 AIM0 Tako ,a j "og32 3nap!,iti
o+tlji%o+t t+ta ?> 3tiIaja na njgo%3 +pIi/ino+t0 O%o" 3 p!ilog i, po,atak ,a j o,
G5K paIijnata p!i"ljni# na o,ljnja +a n,ijagno+ti/iko%ani" EKG9p!i"no" ?!>i# i
o+tlji%i# t+to%a >a CKH49 olak1ana ,ijagno>a AIM0 Uono j ,a j ko, o%i# paIijnata
o+tlji%o+t t+ta 3 !ang3 o, :6K ,o 84K 3 n3lto" +at3 i o, E4K ,o :55K 3 =0 +at3 nakon
in/a!kta0 O%aj po,atak +3g!i1 ,a ?i !anija p!ak+a 3>o!ko%anja 3 59 :40 i 4;0 +at3 "ogla
?iti >a"njna 3>o!Ii"a 3 59 =9 80 i E0 +at3 nakon in/a!kta kako ?i + ,o?ila ?!$a i
+ig3!nija +lika o +tanj3 paIijnta0 Cilj j ,a t+t ?3, ?!> i ,a i"a analitik3 o+tlji%o+t
tak%3 ,a ,tkt3j i naj"anji po!a+t ni%oa CKH4 toko" p!%i# +ati nakon poja% +i"pto"a
AIM0 TakoJ9 t!?a %o,iti !a3na o 3tiIaj3 %nt3alno p!i+3tn CK i> o1t2nog
+kltnog "i1i2a0 U to" +l3aj39 ,o2i 2 ,o po%2anja 3k3pn CK9 a to na+ "o$ na%+ti
na pog!1n3 p!ogno>30
@AKTAT DEAIDROGENA.A
Laktat ,#i,!ogna>a @LD(A j n>i" koji j +"1tn 3 Iitopla>"i 2lija !a>liiti# tki%a0
O%aj n>i" katali>3j !akIij3 +t%a!anja pi!3%ata i> laktata0 Naj%2a akti%no+t LD(
p!onaJna j 3 +kltni" "i1i2i"a9 jt!i9 +!I39 ?3?!>i"a i I!%ni" k!%ni" >!nIi"a0
Elkt!o/o!>o" na !a>liiti" po,loga"a i 3 ko"?inaIiji +a i"3no#"ij+ki"
i+piti%anji"a p!onaJno j naj"anj pt i>on>i"a LD(0 O% >i" in ,%a !a>liita
tipa ppti,a9 M @i> "i1i2aA i ( @i> +!IaA9 koji +3 3j,injni kao ti!i ppti,n +3?j,iniI0
LD(H: @(;A i"a naj%23 lkt!o/o!t+k3 pok!tlji%o+t ka ano,i ,ok LD(HG @M;A o+taj
?li$ kato,i0 LD(H: j p!onaJn 3 naj%2oj konInt!aIiji 3 +!I39 ?3?!>i"a @3 ko!tk+3A i
!it!oIiti"a9 a LD(HG 3 jt!i i +kltni" "i1i2i"a0 I>on>i"i LD(H4 @(=MA9 LD(H=
:G
@(4M4A i LD(H; @(M=A +3 po!, o%i#9 takoJ9 p!onaJni i 3 ,!3gi" tki%i"a0 O?>i!o"
na to ,a "o$ ,a + po%2a 3 !a>liiti" ?ol+ti"a9 LD( nij tki%no +pIi/ian n>i"+ki
"a!k!0 S!ano +pIi/ini LD(H: "o$ ,%o+t!3ko ,a + po%2a 3 +kltni" "i1i2i"a @o,
:5K ,o 45K o, 3k3pn akti%no+ti LD(A toko" ,%ton,ljnog p!io,a akti%nog
t!ninga ili t!anja0 O+i" 3k3pnog LD( i LD(H:9 po%2a%a + i o,no+ LD(H:7LD(H40
LD( i>on>i"i i 3k3pna LD( akti%no+t + o,!J3j3 >aj,no +a ,!3gi" "a!k!i"a >a
,tkIij3 AIM0 Ko, o%i# paIijnata po!a+t LD( + ja%lja 3 tok3 p!%i# :4H:B +ati nakon
poja% +i"pto"a9 a pik 3 tok3 ;BH64 +ata9 ,ok + po%!atak 3 !/!ntni int!%al ,1a%a tk
nakon 1+t ,o ,+t ,ana0 Ko"pltan +pkta! i>on>i"a + ,o?ija nakon lkt!o/o!t+k
+pa!aIij0 )o+toj nk in#i?ito!n t#nik koji"a j "og32 i>"!iti LD(H: ?>
+pa!aIij o, ,!3gi# i>on>i"a0 Na t!$i1t3 + nala> i"3not+to%i koji takoJ ko!i+t
"onoklon+ka antitla >a o,!Ji%anj (BD( @#i,!ok+iH?3ti!at ,#i,!ogna>aA koj3 in
LD(H: i LD(H 40 LD(H: !a+t 3 ok%i!3 :5H:4 +ati9 +a piko" 3 tok3 64H:;; +ata9 a %!a2a
+ na no!"aln3 %!,no+t otp!ilik nakon ,+t ,ana9 pa!allno +a 3k3pni" LD(0 Z?og
o%og p!o,3$nog %!"na pol3li"inaIij9 LD(H: j o+tlji%iji @E5KA "a!k! o, CK >a
in/a!kt ka,a j o, njga p!o1lo %i1 o, 4; +ata0 LD(H: !a+t 3 +!3"3 %i1 o, LD(H4
nakon AIM @o,no+ LD(H:7LD(H4 j X :95A i i"a o+tlji%o+t oko 6GK 3 paIijnata >a
koj + +3"nja ,a +3 p!t!pli o%o ak3tno +tanj0
MIOG@O/IN
Mioglo?in j ki+onikH%>3j32i p!otin +!ani# i +kltni# "i1i2a0 Mala "olk3l+ka
t$ina i to 1to j +"1tn 3 Iitopla>"i 2lij j !a>log 1to "ioglo?in "o$ ,a + !ano
poja%i 3 Ii!k3laIiji po po%!,i "i1i2a0 On i"a k!atko %!" pol3li"inaIij o, :5
"in3ta0 )o!a+t "ioglo?ina 3 +!3"3 + ,ogaJa 3+l, po%!, i +kltni# i +!ani# "i1i2a0
&ak i naj"anja po%!,a +kltnog "i1i2a "o$ ?iti 3>!ok %i+oki# konInt!aIija 3 +!3"3
1to >a po+l,iI3 "o$ ,a ,a pog!1n3 int!p!taIij3 o po%!,i "ioka!,a0
Mioglo?in + "!i 3 +!3"3 RIA "to,o" @!a,io i""3noa++aQA9 latk+ agl3tinaIijo"9
R+n,%iS i"3not+to" ?a>i!no" na p!i"ni "onoklon+ki# antitla0 I"3not+to%i koji
:8
ko!i+t poliklon+ka antitla ni+3 p!i#%atlji%i >a la?o!ato!ij+k3 p!ak+3 >?og ,3gog %!"na
i>%oJnja t+ta @,o 4 +ataA0 Iako +3 !aniji t+to%i latk+ agl3tinaIij o?>?,ili %23 ?!>in3
@i ,o =5 "inA9 ipak + n ko!i+t j! +3 +"ik%antitati%ni0 B!>i i k%antitati%ni t+to%i kao
1to +3 n/lo"t!ija @:GH=5 "inA9 t3!?i,i"t!ija @4 "inA i /l3o!+InIija @B "inA +3
ko"!Iijali>o%ani 3%oJnj" "onoklon+ki# antitla0 S%aka o, o%i# t#nika i"a ,o?!
analitik ka!akt!i+tik0 Ra>%oj" t#nologij +"anj3j + %!" i>%oJnja
i"3not+to%a0
Za "ioglo?in !/!ntn %!,no+ti %a!i!aj3 3 o,no+3 na +ta!o+t9 !a+3 i pol0 Mioglo?in j
po>nat po o,linoj !anoj o+tlji%o+ti ko, in/a!kta "ioka!,a9 ali + ipak n ko!i+ti 3 1i!okoj
klinikoj p!ak+i0 Naj%2i n,o+tatak j njgo%a ni+ka tki%na +pIi/ino+t0 Kao o,linog
"a!k!a ka!akt!i1 ga to 1to + 3 +!3"3 o+lo?o,i %o"a !ano nakon po%!, "ioka!,a
ak i p! CKHMB i t!oponina0 St3,ij poka>3j3 ,a j "ioglo?in %o"a o+tlji% ?io"a!k!
>a AIM @E5H:55KA kao 1to to poka>3j3 Slik :50 i ::0 KonInt!aIij %2 o, njgo%
!/!ntn %!,no+ti + poja%lj3j3 %2 nakon j,nog +ata o, in/a!kta9 a pik o+tlji%o+ti j 3
op+g3 4H:4 +ati0 Mioglo?in + ?!>o li"ini1 i> o!gani>"a tako ,a + i o+tlji%o+t
+"anj3j %2 nakon :4 +ati o, in/a!kta "ioka!,a0 Ka,a ?i + ko!i+tio kao "a!k! >a
,tkIij3 AIM 3 p!%i# ti!i +ata9 "ioglo?in ?i poka>ao >naajno %i+ok %!,no+ti >a
!a>lik3 o, CKH4 i t!oponina koji +3 jo1 3%k 3 int!%al !/!ntni# %!,no+ti0 I kao 1to j
!anij po"n3to9 "ioglo?in + n ko!i+ti 3 klinikoj p!ak+i j! i"a ni+k3 +pIi/ino+t
@85KA0 Kao "og32no+t 3nap!Ji%anja klinik +pIi/ino+ti p!o?alo + +a o,!Ji%anj"
ka!?oan#i,!a> III @KA IIIA0 Tako j ko, paIijnata +a AIM 3t%!Jno ,a j KA III o+tala
np!o"njna ,ok +3 + CKH4 i "ioglo?in po%2ali0 Za !a>lik3 o, nji#9 paIijnti +a
t1ko" t!a3"o" +kltni# "i1i2a i"ali +3 po%2ana +%a t!i pa!a"t!a 3 +!3"30 O%o j
j,an nain kako "o$ ,a + po%2a +pIi/ino+t "iglo?in+kog t+ta po"o23 KA III koja
j +pIi/ina >a +kltn "i1i20 MJ3ti"9 ,o ,ana+ j jo1 3%k +% o+talo na +t3,ija"a0
C 3 REAKTIVNI PROTEIN
CR) @C-reactive proteinA j !aktant ak3tn /a> koji + po%2a%a ko, in/kti%ni# +tanja0
On + na>i%a i %i+oko o+tlji%i CR) @#+CR) H high sensitivity CRP) j! + ,tkt3j 3
:6
ni+ki" konInt!aIija"a0 S o?>i!o" na to ,a j in/la"ato!na ko"ponnta9 #+CR) "o$
?iti "a!k! ak3tni# i #!onini# at!o+kl!ot+ki# p!oI+a0 Ko"ponnt koj +ti"3li13 CR)
+3 TNF @tissue necrosis factorA i ILH: @int!l3kin :A >a koga + +"at!a ,a p!ko
+ti"3laIij ILH8 ,o%o,i ,o po%2anja +int> CR)Ha 3 jt!i0 Dana+ + ja+no >na ,a CR)
+a" "o$ ,a po%2a in/la"ato!ni i p!ot!o"?in+ki o,go%o!0 )o+toj ?!ojni t+to%i >a
#+CR) i +tan,a!,ni p!otokoli >a nji#o%o i>%oJnj0 Sko!ija i+t!a$i%anja p!,la$3 ,a +
po,aIi o #+CR)H3 3,!3$ +a po,aIi"a o LDL %!,no+ti"a ,a ?i + a,k%atno p!,%i,o
!i>ik o, at!o+kl!o>0 Ka,a +3 njgo% %!,no+ti "anj o, : "g7L go%o!i"o o ni+ko"
!i>ik3 ,ok +3 %!,no+ti :H= "g7L i %!,no+ti %2 o, = "g7L9 !i>iIi +!,njg i %i+okog
ni%oa0 Za paIijnt +a AKS9 potn %!,no+ti #+CR) i"aj3 p!ogno+tiki >naaj0 V2ina
+t3,ija poka>3j ,a j >naaj "!nja +!anog t!oponina ,o"inantan >a k!atko!on39 a ,a
>aj,no +a #+CR)Ho" ,aj ,3go!on3 p!ogno>30 Ipak9 o%o n "o!a 3%k ,a ?3, p!a%ilo0
SERUMSKI AMI@OID
S!3"+ki a"iloi, p!otin A j p!otin ak3tn /a>0 Mo$ + o,!Ji%ati 3 ko"?inaIiji +a
#+CR)Ho"9 ali + to 3gla%no" n !a,i j! n po+toj +tan,a!,i>o%ani analitiki t+to%i i
+t3,ij o !/!ntni" %!,no+ti"a0
CITOKINI
)o+toj !a>liiti +ti"3li132i i in#i?ito!ni int!l3kini >a koj + +"at!a ,a in,i!ktno 3ti3
na po!a+t CR)Ha i !a>%oj at!o+kl!o> i ak3tni# %a+k3la!ni# ,ogaJaja0 To +3. TNF9 ILH:9
ILH89 ILHB9 ILH:49 ILH :B0 Oni ili +ti"3li13 ili in#i?i!aj3 l3koIit p!ko TH2lij+ki
po+!,o%ani# p!oI+a0 &+to o%i Iitokini in#i?i!aj3 i %>3j32 p!otin i tako "o,3li13
nji#o% /kt0 Z?og npo+tojanja +tan,a!,i>o%ani# t+to%a9 Iitokini + n o,!J3j3
!3tin+ki0
:B
MI?E@OPEROKSIDA.A
Mijlop!ok+i,a>a j n>i" koji + o+lo?aJa nakon ag!gaIij n3t!o/ila ka,a in,3k3j
akti%ni in/la"ato!ni o,go%o! 3 k!%no" +3,30 O%aj n>i" j po%2an ko, paIijnata +a
AKS0 )!% p!ogno+tik +t3,ij +3 o#!a?!3j32 "a,a n po+toji a,k%atna 3po!,i%o+t +a
,!3gi" anali>a"a0 N po+toj +tan,a!,ni t+to%i i !/!ntn %!,no+ti >a o,!Ji%anj
"ijlop!ok+i,a>0
FOSFO@IPA.A A# UDRUBENA SA @IPOPROTEINOM
Lp )LA4 @lipoprotein-associated phospholipase A2A j lipop!otin 3,!3$n +a LDL i
+"at!a + in/la"ato!ni" "a!k!o"0 )!%o + +"at!alo ,a j /akto! akti%aIij t!o"?oIita9
tj0 @)AFHplatlt aIti%ating /aIto!A aItilH#i,!ola>a0 Ona p!o,i! 3 ok+i,o%an lipi, i
in,3k3j /!ag"ntaIij30 O%i lipi,ni /!ag"nti po%2a%aj3 n,otln3 a,#>ij3 i po,+ti3
at!o+kl!o>30 Lp )LA4 + k+p!i"3j 3 nk!otino" j>g!3 ko!ona!ni# l>ija i p!oi>%o,i
njn n>i"+k akti%no+ti ,op!ino+ in/la"aIiji i 2lij+koj +"!ti9 kao i o+tlji%o+ti plaka
na !3pt3!0
OKSIDOVANI @D@
LDL j j,an o, klj3ni# ko"ponnti koji ,o%o,i ,o !a>%oja at!o+kl!o>0 )o+toji
nkoliko "to,a koji"a + ok+i,o%ani LDL o,!J3j9 ali + ,o?ijaj3 !a>liiti !>3ltati0
Di!ktna i,nti/ikaIija j "og32a +a antitli"a i ona poka>3j ,a + ok+i,o%ani LDL
o+lo?aJa i> k!%nog +3,a0 O%ak%a "to,a ,oka>3j i p!i+3+t%o lipop!otina @ Lp aA nakon
ak3tnog ,ogaJaja0
META@OPROTEINA.E MATRIKSA
MM) @"at!iY "tallop!otina++A +3 n>i"i koj "og3 ,a !a>g!aJ3j3 kolagn "at!ik+a i
3 ko!ona!ni" a!t!ija"a i 3 "ioka!,30 On +3 klj3n 3 p!oI+3 !"o,lo%anja
:E
ko!ona!ni# a!t!ija i7ili +!Ia nakon ak3tnog +!anog ,ogaJaja0 TakoJ9 o,go%o!n +3 >a
,+ta?ili>aIij3 at!o+kl!ot+kog plaka0 Za +a,a9 n po+toj +tan,a!,i>o%an "to, i
!/!ntn %!,no+ti >a o%aj pa!a"t!0
.AK@?UAK
S!ani ?io"a!k!i + intn>i%no ko!i+t 3 ko, lj3,i i "ali# $i%otinja 3 %t!ina!+koj
",iIini >a ,ijagno>3 i p!ogno>3 +!ani# o?oljnja0 O%aj t!n, 2 + ,alj !a>%ijati i 3
konj+koj ",iIini i po,+tiIati +pIi/in +t3,ij i !a>%oj t+to%a0 T!n3tno9 +a"o +!ani
t!oponin I + "o$ ko!i+titi 3 konj+koj klinikoj p!ak+i >a ,ijagno>3 o1t2nja "ioka!,a9
i" + >a"nj3j3 "anj +pIi/ini LD( i CKHMB n>i"i0 U ?3,32no+ti 9 nat!i3!tini
ppti,i 2 po+tati %a$niji 3 p!oIni ,ijagno> i p!ogno> ?ol+ti +!Ia ko, konja0
@ITERATURA
:0T# 3+ o/ Ia!,iaI ?io"a!k!+ in %t!ina!Q ",iIin. t# N3in p!+pIti%
N0 Van D! Vkn+9 A0 DIlo,t9 D0 D Cl!IN9 T0 V!#Qn9 G0 %an Loon
Dpa!t"nt o/ La!g Ani"al Int!nal M,iIin
FaI3ltQ o/ Vt!ina!Q M,iIin9 G#nt Uni%!+itQ
Sali+?3!Qlaan :==9 EB45 M!l?k9 Blgi3"
40 FUNKCI'A SRCA I BIOMARKERI KARDIOVASKULARNI( OBOL'EN'A
)!o/0 ,! S%tlana Ignjato%i2
45