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In October 2003, researchers at The Cleveland Clinic Heart Center identified a new blood test to determine whether a patient is in imminent danger of a myocardial infarction or death. The New England Journal of Medicine reported that this new test measured the amount of myeloperoxidase (MPO) found in the bloodstream. MPO is an enzyme found in disease-fighting white blood cells,
Researchers involved in the study examined 604 sequential patients who were admitted to the emergency room with chest pain. Prior to this study, the existing laboratory-based risk assessments had only a 50% success rate predicting cardiac risk over a 30 day to 6 month period. This study indicated that measuring the MPO levels in the bloodstream improved that rate to 95%.
Previous Cleveland Clinic research had indicated that an increased level of MPO could signal a patient’s risk for heart disease. However, this was the first study that indicated MPO levels in plasma could determine if a patient was at a high risk for heart attack, in need of angioplasty or bypass surgery, or at an increased risk for cardiac death within six months. Prior to this study, the industry standard in cardiac markers was C-reactive protein (CRP). But in head-to-head studies, CRP was found to be far less effective than MPO.
In 2005, PrognostiX became the first and only company so far to receive FDA approval for an in vitro diagnostic myeloperoxidase product, called CardioMPO. CardioMPO is also the only enzyme-linked immunosorbant assay commercially available that provides quantitative recoveries for MPO.
In addition, MPO levels have been found to predict the risk of other major adverse cardiac events such as ischemia, and congestive heart failure, as well as heart cancer, Multiple Sclerosis, and other ailments.
MPO is a peroxidase enzyme, most abundantly present in neutrophil granulocytes (a subtype of white blood cells). It is a lysosomal protein stored in azurophilic granules of the neutrophil. MPO has a heme pigment, which causes its green color in secretions rich in neutrophils, such as pus and some forms of mucus. In the human body, MPO produces hypochlorous acid (HOCl) from hydrogen peroxide (H2O2) and chloride anion (Cl-) during the neutrophil's respiratory burst, and requires heme as a cofactor. Hypochlorous acid is cytotoxic, so the MPO is used by the neutrophil to kill bacteria and other pathogens.
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