The role of antibody-based troponin detection in cardiovascular disease: A critical assessment

J Immunol Methods. 2021 Oct:497:113108. doi: 10.1016/j.jim.2021.113108. Epub 2021 Jul 28.

Abstract

Cardiovascular disease has remained the world's biggest killer for 30 years. To aid in the diagnosis and prognosis of patients suffering cardiovascular-related disease accurate detection methods are essential. For over 20 years, the cardiac-specific troponins, I (cTnI) and T (cTnT), have acted as sensitive and specific biomarkers to assist in the diagnosis of various types of heart diseases. Various cardiovascular complications were commonly detected in patients with COVID-19, where cTn elevation is detectable, which suggested potential prognostic value of cTn in COVID-19-infected patients. Detection of these biomarkers circulating in the bloodstream is generally facilitated by immunoassays employing cTnI- and/or cTnT-specific antibodies. While several anti-troponin assays are commercially available, there are still obstacles to overcome to achieve optimal troponin detection. Such obstacles include the proteolytic degradation of N and C terminals on cTnI, epitope occlusion of troponin binding-sites by the cTnI/cTnT complex, cross reactivity of antibodies with skeletal troponins or assay interference caused by human anti-species antibodies. Therefore, further research into multi-antibody based platforms, multi-epitope targeting and rigorous validation of immunoassays is required to ensure accurate measurements. Moreover, in combination with various technical advances (e.g. microfluidics), antibody-based troponin detection systems can be more sensitive and rapid for incorporation into portable biosensor systems to be used at point-of care.

Keywords: Antibody; COVID-19; Cardiovascular disease; Detection; Troponin.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antibodies / blood*
  • Antibodies / immunology
  • Biomarkers / blood*
  • COVID-19 / complications
  • COVID-19 / diagnosis
  • COVID-19 / virology
  • Cardiovascular Diseases / blood*
  • Cardiovascular Diseases / complications
  • Cardiovascular Diseases / diagnosis
  • Humans
  • Immunoassay / methods*
  • Prognosis
  • SARS-CoV-2 / immunology
  • SARS-CoV-2 / physiology
  • Troponin I / blood*
  • Troponin I / immunology
  • Troponin T / blood*
  • Troponin T / immunology

Substances

  • Antibodies
  • Biomarkers
  • Troponin I
  • Troponin T