Horvát-Karajz K, Csepregi A, Nemesánszky E, Tulassay Z, Selmeci L, Szalay F
Altalános Orvostudományi Kar, II. Belgyógyászati Klinika, Semmelweis Egyetem, Budapest.
Orv Hetil. 2000 Apr 30;141(18):963-5.
Neutral endopeptidase (neprilysin; EC 3.4.24.11) is present in the brush border membrane, for example in the bile ducts. We investigated serum neprilysin activity and its correlation with cholestatic markers in patients with primary biliary cirrhosis. Sera of 39 patients with primary biliary cirrhosis (37 females, 2 males, mean age 45 years, range 24-71 years) were investigated. Twenty-seven healthy volunteer subjects served as control. Serum neprilysin activity was measured by a sensitive microplate-based continuous monitoring kinetic assay. Succinyl-alanyl-alanyl-phenyl-alanyl-4- nitroanilide was used as substrate. For statistical analysis Kruskal-Wallis ANOVA by ranks and Mann-Whitney U test were used. The neprilysin activities were significantly higher in stages III (mean 13.2 +/- SD 10.8 U/l) and IV (21.8 +/- 17.5) than in the control subjects (2.4 +/- 2.9, p < 0.01). There was no significant difference in neprilysin activity between the patients with stages I and II, or between stage I + II (2.88 +/- 3.0) and the control. Positive correlation was found between the activity of neprilysin and serum bilirubin, alkaline-phosphatase and gamma-glutamyl-transferase (p < 0.005 for each). In this study we confirmed that serum neprilysin activity is elevated in patients with primary biliary cirrhosis at advanced stages and the elevation correlated with the cholestatic markers. The increased neprilysin activity seems to be an indicator for the severity and progression of the disease.
中性内肽酶（脑啡肽酶；EC 3.4.24.11）存在于刷状缘膜中，例如胆管中。我们研究了原发性胆汁性肝硬化患者血清脑啡肽酶活性及其与胆汁淤积标志物的相关性。对39例原发性胆汁性肝硬化患者（37例女性，2例男性，平均年龄45岁，范围24 - 71岁）的血清进行了研究。27名健康志愿者作为对照。血清脑啡肽酶活性通过基于微孔板的灵敏连续监测动力学测定法进行测量。以琥珀酰 - 丙氨酰 - 丙氨酰 - 苯丙氨酰 - 4 - 硝基苯胺作为底物。统计分析采用Kruskal - Wallis秩和检验与Mann - Whitney U检验。脑啡肽酶活性在Ⅲ期（平均13.2±标准差10.8 U/L）和Ⅳ期（21.8±17.5）显著高于对照受试者（2.4±2.9，p < 0.01）。Ⅰ期和Ⅱ期患者之间，或Ⅰ + Ⅱ期（2.88±3.0）与对照之间，脑啡肽酶活性无显著差异。脑啡肽酶活性与血清胆红素、碱性磷酸酶和γ - 谷氨酰转移酶呈正相关（每项p < 0.005）。在本研究中，我们证实原发性胆汁性肝硬化晚期患者血清脑啡肽酶活性升高，且这种升高与胆汁淤积标志物相关。脑啡肽酶活性增加似乎是疾病严重程度和进展的一个指标。
