Bellini C, Carlomagno A, Piccoli A, Di Francesco L, Torregrossa G, Leonetti Luparini R, Germanò G, Giarrizzo C, Ferri C, Santucci A
Istituto di I Clinica Medica, Università degli Studi di Roma La Sapienza.
Ann Ital Med Int. 1991 Oct-Dec;6(4):369-74.
Since the reduced kallikrein excretion demonstrated in essential hypertension suggested the possibility of an impairment in the renal kallikrein-kinin system, we decided to evaluate the efficacy and safety of oral kallikrein administration (glandular kallikrein derived from porcine pancreas) in 30 essential hypertensive subjects (21 males, 9 females, age range 34-62 years). Twenty subjects took 150 IU kallikrein t.i.d. for eight days; during this period their sodium intake remained normal (120 mEq Na+/die). Ten subjects took placebo. After the trial period, urinary kallikrein in the active group increased from 0.9 +/- 0.4 U/24 h (normal value greater than 1.2 U/24 h) to 1.6 +/- 1 U/24 h (p less than 0.05); systolic and diastolic blood pressure decreased respectively from 154.6 +/- 13.8 mmHg to 140.3 +/- 12.5 mmHg (p less than 0.01) and from 92.5 +/- 1.5 mmHg to 86 +/- 3.9 mmHg (p less than 0.025); urinary sodium and potassium excretion increased respectively from 96.7 +/- 17 mEq/24 h to 119.1 +/- 32.3 mEq/24 h (p less than 0.05) and from 36.7 +/- 11 mEq/24 h to 43.5 +/- 12.8 mEq/24 h (p less than 0.05). One patient in the kallikrein group suffered a transient episode of gastric pain. No modifications of the parameters evaluated were observed in the placebo group. We conclude that kallikrein has a mild hypotensive effect in hypertensive subjects and is generally well-tolerated. Its antihypertensive effect is probably due to the sodiuretic action of the substance.
由于原发性高血压患者中尿激肽释放酶排泄减少提示肾激肽释放酶 - 激肽系统受损的可能性，我们决定评估口服激肽释放酶（源自猪胰腺的腺激肽释放酶）对30例原发性高血压患者（21例男性，9例女性，年龄范围34 - 62岁）的疗效和安全性。20例受试者每日三次服用150 IU激肽释放酶，共8天；在此期间他们的钠摄入量保持正常（120 mEq Na⁺/天）。10例受试者服用安慰剂。试验期结束后，活性组的尿激肽释放酶从0.9±0.4 U/24小时（正常值大于1.2 U/24小时）增至1.6±1 U/24小时（p＜0.05）；收缩压和舒张压分别从154.6±13.8 mmHg降至140.3±12.5 mmHg（p＜0.01）以及从92.5±1.5 mmHg降至86±3.9 mmHg（p＜0.025）；尿钠和钾排泄分别从96.7±17 mEq/24小时增至119.1±32.3 mEq/24小时（p＜0.05）以及从36.7±11 mEq/24小时增至43.5±12.8 mEq/24小时（p＜0.05）。激肽释放酶组有1例患者出现短暂的胃痛发作。安慰剂组未观察到所评估参数的改变。我们得出结论，激肽释放酶对高血压患者有轻度降压作用，且一般耐受性良好。其降压作用可能归因于该物质的利钠作用。
