Ishizaka Y, Yamamoto Y, Tanaka M, Kato F, Ishizaka Y, Yokota N, Kato J, Kitamura K, Eto T, Kangawa K
First Department of Internal Medicine, Miyazaki Medical College, Kiyotake, Japan.
Clin Nephrol. 1995 Apr;43(4):237-42.
Plasma brain natriuretic peptide (BNP) levels have been reported to increase in patients with heart failure and end-stage renal disease (ESRD); however, little is known about molecular forms of plasma BNP that increase in these diseases. In the present study, we analyzed the molecular forms of plasma BNP in ESRD patients of both before (pre-) and after (post-) hemodialysis (HD) state. The plasma extract was analyzed by gel filtration on a TSK-GEL G2000 SW column followed by a RIA for both BNP and atrial natriuretic peptide (ANP). In the pre-HD patients, a 14- to 2300-fold increase in plasma level of immunoreactive (ir-) BNP was observed when compared to normal controls. A ratio of BNP-32 to g-BNP (pro BNP) in plasma from the patients was much larger than that in plasma from normal subjects, indicating that the high plasma level of ir-BNP level in the patients on HD largely results from a marked increase in BNP-32. HD significantly (P < 0.01) lowered the plasma levels of both BNP-32 and g-BNP with a greater reduction in BNP-32 than in g-BNP. Whereas, a-ANP was a main molecular form of plasma ANP in both pre- and post-HD plasma. These results suggest that plasma BNP-32 plays an important role in the sodium-fluid balance and that secretion and metabolism of BNP may differ from those of ANP in the HD patients.
据报道，心力衰竭和终末期肾病（ESRD）患者的血浆脑钠肽（BNP）水平会升高；然而，对于这些疾病中血浆BNP升高的分子形式知之甚少。在本研究中，我们分析了处于血液透析（HD）前（预）后（后）状态的ESRD患者血浆BNP的分子形式。血浆提取物先通过TSK-GEL G2000 SW柱进行凝胶过滤分析，然后对BNP和心房利钠肽（ANP）进行放射免疫分析（RIA）。在HD前患者中，与正常对照组相比，免疫反应性（ir-）BNP的血浆水平升高了14至2300倍。患者血浆中BNP-32与γ-BNP（前BNP）的比值远大于正常受试者血浆中的比值，表明HD患者血浆中ir-BNP水平升高主要是由于BNP-32显著增加所致。HD显著（P < 0.01）降低了BNP-32和γ-BNP的血浆水平，且BNP-32的降低幅度大于γ-BNP。而α-ANP是HD前后血浆中ANP的主要分子形式。这些结果表明，血浆BNP-32在钠-水平衡中起重要作用，并且HD患者中BNP的分泌和代谢可能与ANP不同。
