Instant Insights: Instant Insights: Myeloperoxidase Uncovered
[00:00:00]
Welcome to Healthier World with Quest Diagnostics. Our goal is to prompt action from insight as we keep you up to date on current clinical and diagnostic topics in cardiovascular, metabolic, endocrine, and wellness medicine.
Maeson: Welcome to a special episode series called Instant Insights, a podcast episode designed to give you quick and highly impactful clinical pearls in just a few minutes.
I am Dr. Maeson Latsko, and today. We explore Myeloperoxidase, a vascular specific inflammatory marker that can indicate risk for cardiometabolic disease and all cause mortality. We break down the biology and the function of Myeloperoxidase, explore its contribution to vascular inflammation, and discuss its indication as a biomarker for vulnerable plaque in arteries.
Let's get started. Most heart attacks and strokes are not caused by gradual narrowing of arteries, [00:01:00] but by something much more sudden. Plaque rupture. Think of plaque in your arteries like a volcano. It sits quietly for years, and then suddenly it ruptures, triggering a clot that blocks blood flow and causes a heart attack or a stroke.
So what if we could predict the vulnerability of that volcano? That's where Myeloperoxidase comes in. Myeloperoxidase or MPO is an enzyme released by immune cells, specifically neutrophils and monocytes during inflammation. And it's part of the body's natural defense system.
Myeloperoxidase is normally found inside immune cells or within tissue at sites of infection or injury. However, when Myeloperoxidase is found freely circulating in the bloodstream, it can be a red flag for atherosclerotic disease. Why? When cracks and fissures are present in the collagen cap, which is intended to keep plaque stable. Neutrophil C and identify this injury and release Myeloperoxidase into the bloodstream [00:02:00]. High levels of MPO therefore predict the presence of soft and unstable plaque that's most likely to rupture and cause a heart attack or a stroke.
Myeloperoxidase is involved in oxidative stress and inflammation, which are two key players in the development of cardiometabolic disease. In fact, a large study at Quest Diagnostics has shown that a high level of Myeloperoxidase predicts five-year mortality due to heart attacks, cancer, and other inflammatory conditions. While lower Myeloperoxidase Levels are associated with a lower risk for mortality.
And the relationship between MPO and cardiovascular events is independent of traditional risk factors like cholesterol and blood pressure. while MPO works in conjunction with other biomarkers like high sensitivity CRP, to improve risk prediction of cardiovascular disease.
But it's not just about cardiovascular disease. In fact, the list of chronic diseases that are [00:03:00] associated with Myeloperoxidase is long and growing. Elevated Myeloperoxidase has been linked to atherosclerosis, insulin resistance, metabolic dysfunction, progressive liver fibrosis, and renal disease.
A recent study by Quest Diagnostics identified that high MPO was associated with about 70% increased odds of impaired kidney function, and about two to threefold increased odds of having high fibrosis scores. These findings really demonstrate the commonality of cardiometabolic disorders across multiple organs, and identifying high MPO can indicate that your patient has risks not only in cardiovascular events, but also for other comorbid conditions like kidney disease and liver disease.
So, what do we do about it? First, we need to look beyond traditional risk factors. If somebody has high MPO, they may be at risk for cardiometabolic disease even if their cholesterol and blood pressure are normal. [00:04:00]
Furthermore, MPO allows us to investigate the root cause of inflammation and white blood cell activation. When a patient has elevated MPO, the first potential risk factors to look at should be cardiovascular in nature. Does that patient also have elevated lipids, insulin resistance, or hypertension. Additional etiologies can cause white blood cell activation resulting in an elevated MPO and an increase in cardiovascular risk. These etiologies include autoimmune conditions such as rheumatoid arthritis, vasculitis, bone marrow, dyscrasia, periodontal disease, sleep apnea, and atrial fibrillation. Addressing the root cause of risk factors can mitigate unstable plaque and reduce the likelihood of having an event.
Ultimately understanding NPOs role helps us to take a proactive root cause approach to cardiovascular and metabolic risk. This isn't just about treating symptoms, it's finding the [00:05:00] underlying inflammatory process , and addressing it before it can lead to cardiometabolic disease.
So, whether you're a clinician or a patient listening in today, keep an eye on Myeloperoxidase or MPO. Because when it comes to heart disease sometimes what we can't see on a standard lipid panel is what actually matters most.
That's a wrap on this episode of Healthier World with Quest Diagnostics. Please, follow us on your favorite podcast app and be sure to check out Quest Diagnostics Clinical Education Center for more resources, including educational webinars and research publications. Thank you for joining us today as we work to create a healthier world, one life at a time.