Çakırköse Özlem, Kesici Uǧur, Kesici Sevgi, Sipahi Mehmet, Tokgöz Vehbi Yavuz, Güvendi Gülname Fındık, Avcı Esin, Şen Tuǧba Mazlum, Kara Hanife, Tosun Alptekin, Küçükarslan Mustafa Nezihi
Giresun University, Medical Faculty, Department of Cardiovascular Surgery, Giresun, Türkiye.
Health Science University, Prof. Dr. Cemil Tascioglu City Hospital, Department of General Surgery.
Malawi Med J. 2024 Oct 16;36(3):220-226. doi: 10.4314/mmj.v36i3.8. eCollection 2024 Oct.
C-type Natriuretic Peptide (CNP) is the third natriuretic peptide (NP) identified from the nervous system and endothelial cells. CNP is believed to be produced locally in tubular cells and glomeruli of kidneys. We aim to determine the clinical value of CNP levels at lower extremity muscle ischemia/reperfusion (I/R), kidney I/R, and both I/R models and evaluate them in laboratory practices.
This study is an original experimental study and was carried out on a total of 40 rats. (8-12 weeks and 321±69 gr). The rats were assigned into 5 groups, each containing 8 rats. CNP levels in the plasma were evaluated in the control group. CNP and muscle biopsies were held after ischemia/reperfusion from the left lower extremity in Group E and bilateral muscle ischemia/reperfusion in Group BE. CNP and renal biopsies were held after right nephrectomy+left renal I/R at Group R. CNP, muscle, and renal biopsies were held after right nefrectomy+left renal ischemia+bilateral renal ischemia in Group BER.
The plasma level of CNP in the control group was determined as 144.99±33.04 pg/ml. There was no significant difference between groups at plasma CNP levels in predicting ischemia. Although in terms of reperfusion between Control-Group E, Control-Group BER, Group E-Group BE, Group E-Group R, Group BE-Group BER, Group R-Group BER; statistical significance was determined (p<0.05).
This study suggests that as a laboratory test, the endothelial-derived vasodilator CNP level cannot predict the location and degree of muscle and renal ischemia at the specified time. Similarly, the CNP level is valuable in evaluating adjunct muscle reperfusion to renal reperfusion. As a result, CNP levels may not be useful in predicting ischemia at a particular period, but they can be used to predict reperfusion.
C型利钠肽(CNP)是从神经系统和内皮细胞中鉴定出的第三种利钠肽。据信CNP在肾小管细胞和肾小球中局部产生。我们旨在确定下肢肌肉缺血/再灌注(I/R)、肾脏I/R以及两种I/R模型中CNP水平的临床价值,并在实验室实践中对其进行评估。
本研究是一项原创性实验研究,共对40只大鼠(8 - 12周龄,体重321±69克)进行。大鼠被分为5组,每组8只。评估对照组血浆中的CNP水平。E组在左下肢缺血/再灌注后以及BE组在双侧肌肉缺血/再灌注后进行CNP检测和肌肉活检。R组在右肾切除+左肾I/R后进行CNP检测和肾脏活检。BER组在右肾切除+左肾缺血+双侧肾缺血后进行CNP检测、肌肉和肾脏活检。
对照组血浆CNP水平测定为144.99±33.04 pg/ml。在预测缺血方面,各组血浆CNP水平之间无显著差异。尽管在再灌注方面,对照组与E组、对照组与BER组、E组与BE组、E组与R组、BE组与BER组、R组与BER组之间;差异具有统计学意义(p<0.05)。
本研究表明,作为一项实验室检测,内皮源性血管舒张剂CNP水平在特定时间不能预测肌肉和肾脏缺血的部位及程度。同样,CNP水平在评估肾脏再灌注时的辅助肌肉再灌注方面具有价值。因此,CNP水平在预测特定时期的缺血方面可能无用,但可用于预测再灌注。