Proteomics in the cardiovascular field: Challenges and opportunities for the future cardiology [La proteomica in campo cardiovascolare: sfide ed opportunità per la cardiologia del futuro]

Proteomics is the study of the "proteome", that is the entire protein complement of a genome. However, it is well recognized that the proteome is far more complex than previously suggested by the "one-gene, oneprotein" central dogma of biology. The proteome encompasses all proteins of a cell or organism at a given time, including not only those translated directly from genetic information but also the array of modified proteins arising from alternative splicing of transcripts and post-translational processing, resulting in modifications that have the potential to alter protein structure or biological function. As proteins are involved in virtually every cellular function, control every regulatory mechanism, and are modified in disease states, the proteome dictates the phenotype of the cell and, consequently, the tissue or organ that the cells comprise. This results in a dynamic, ongoing process of protein expression and modifications. The proteome thus consists of information from protein expression, post-translational modifications, processing and turnover, localization and time. Proteomics is aimed at identifying and characterizing these protein changes and, if applied to the field of cardiovascular sciences, it has the potential to reveal those proteins that are associated with pathogenesis and could be potentially used as predictive or prognostic markers. Cardioproteomic is still in its infancy and relatively few cardiovascular diseases have been investigated. However, it has enormously increased our knowledge of the complexity of the myocardium in terms of protein composition at cellular and organelle levels. The cardiac proteome is further complicated by protein post-translational modifications, which may regulate organelle function in physiological and pathological conditions. Therefore, the incorporation of proteomics into cardiovascular research will provide a means of exploring the mechanisms of disease onset and progression. This will in turn ultimately lead to increased efficiency of diagnosis and/or monitoring of treatment, which could dramatically increase the ability of the clinician to recognize cardiovascular disease states at a relatively early stage, and to improve the therapeutic approach.