Division of Neonatology, Department of Pediatrics, University of Heidelberg Medical School, Im Neuenheimer Feld 430, Heidelberg, Germany. lutz.koch @ med.uni-heidelberg.de
Horm Res Paediatr. 2011;76(4):234-9. doi: 10.1159/000329285. Epub 2011 Sep 2.
Though various neurohormonal systems are concurrently activated during birth, their biological effectors are not always easy to measure due to their short half-life in vivo, instability in biological samples, or very low concentrations.
Using a recently discovered chemiluminescence assay, we measured the stable precursor fragments mid-regional pro-atrial natriuretic peptide (MR-proANP), mid-regional pro-adrenomedullin (MR-proADM), C-terminal pro-endothelin-1 (CT-proET-1) and C-terminal pro-vasopressin (CT-proAVP or copeptin) immediately after birth in umbilical venous cord blood from 119 infants with a gestational age of 23-42 weeks and evaluated their possible functions.
Cord blood levels of MR-proANP, MR- proADM, CT-proET-1, and CT-proAVP were considerably higher compared with normal adult levels. The CT-proAVP concentrations were 10-fold higher in term, and 70-fold higher in extremely preterm infants. MR-proANP showed 4-fold higher levels in term infants and 20-fold higher levels in extremely preterm infants. Levels of MR-proADM and CT-proET-1 were 2- to 3-fold higher in preterm and term infants. All four parameters showed significantly decreased values with increasing gestational age and a significant correlation between CT-proET-1 and MR-proADM.
Our results indicate that vasoactive and natriuretic mediators play a functionally relevant role in circulatory transition from fetal to neonatal life.
尽管在分娩过程中会同时激活各种神经激素系统，但由于其体内半衰期短、生物样本不稳定或浓度非常低，其生物效应器并不总是容易测量。
使用最近发现的化学发光测定法，我们测量了稳定的前体片段中区域 pro-心房利钠肽（MR-proANP）、中区域 pro-肾上腺髓质素（MR-proADM）、C 端 pro-内皮素-1（CT-proET-1）和 C 端 pro-加压素（CT-proAVP 或 copeptin），在 119 名胎龄为 23-42 周的婴儿出生后立即从脐静脉脐带血中测量，并评估了它们的可能功能。
与正常成人水平相比，脐带血中 MR-proANP、MR-proADM、CT-proET-1 和 CT-proAVP 的水平明显更高。足月婴儿的 CT-proAVP 浓度高 10 倍，极早产儿的 CT-proAVP 浓度高 70 倍。足月婴儿的 MR-proANP 水平高 4 倍，极早产儿的 MR-proANP 水平高 20 倍。MR-proADM 和 CT-proET-1 的水平在早产儿和足月儿中高 2-3 倍。所有四个参数均随胎龄的增加而显著降低，且 CT-proET-1 与 MR-proADM 之间存在显著相关性。
我们的结果表明，血管活性和利钠肽介质在从胎儿到新生儿生命的循环过渡中发挥着功能相关的作用。
