Høst N B, Sejrsen P, Jensen L T, Haunsø S
Department of Medicine B, Rigshospitalet, University of Copenhagen, Denmark.
Clin Chim Acta. 1996 Nov 29;255(2):183-94. doi: 10.1016/0009-8981(96)06406-6.
Local repair after acute myocardial infarction appears to be reflected by levels in serum of the aminoterminal propeptide of type III procollagen (serum-PIIINP). Furthermore, serum-PIIINP has recently been reported to provide information on prognosis after acute myocardial infarction. However, no attention has yet been paid to the resistance to diffusion offered by the myocardial interstitium. We determined the diffusion coefficient of PIIINP in the interstitium of the globally ischaemic interstitium of the cat (D'37) by means of a "true transient diffusion' method, and compared with the free diffusion in water (D37). D'37 (in cm2 s-1.10(-5) was 0.0157 +/- 0.0005 (mean +/- SEM) (n = 13), and D37 was 0.0624 +/- 0.0024 (n = 12). The mean diffusive progression during 20 min of the concentration profile of [125I]PIIINP into the tissue was calculated to be 0.19 mm. The D'37 of albumin is practically identical to the D'37 of PIIINP, and the myocardium offers a similar resistance to diffusion of PIIINP and albumin, as expressed from the ratio D37/D'37 of approximately 4 for both molecules. PIIINP has a molecular weight of 42,000 Da, is rod shaped and has an overall negative charge. These characteristics explain the similarity in diffusion coefficients of PIIINP and albumin, which has a molecular weight of 69,000 Da. Albumin is known to pass the membrane of the continuous capillaries of the heart, making it very likely that direct exchange of PIIINP between interstitium and capillary plasma can also occur. During one hour of interstitial diffusion PIIINP will have traversed a distance calculated tp correspond to 15-20 capillaries. Therefore, the results support the concept of serum-PIIINP as a direct marker of events taking place locally in the myocardium following acute myocardial infarction.
急性心肌梗死后的局部修复似乎可通过血清中III型前胶原氨基端前肽(血清-PIIINP)水平反映出来。此外,最近有报道称血清-PIIINP可为急性心肌梗死后的预后提供信息。然而,心肌间质对扩散的阻力尚未得到关注。我们通过“真瞬态扩散”方法测定了猫全脑缺血间质中PIIINP的扩散系数(D'37),并与水中的自由扩散系数(D37)进行比较。D'37(单位为cm2 s-1·10(-5))为0.0157±0.0005(平均值±标准误)(n = 13),D37为0.0624±0.0024(n = 12)。计算得出[125I]PIIINP浓度曲线在20分钟内进入组织的平均扩散进程为0.19毫米。白蛋白的D'37与PIIINP的D'37实际相同,心肌对PIIINP和白蛋白扩散的阻力相似,从两种分子的D37/D'37比值约为4即可看出。PIIINP分子量为42,000道尔顿,呈杆状且总体带负电荷。这些特性解释了PIIINP与分子量为69,000道尔顿的白蛋白扩散系数相似的原因。已知白蛋白可通过心脏连续毛细血管的膜,这使得PIIINP在间质与毛细血管血浆之间直接交换也很可能发生。在间质扩散1小时内,PIIINP将穿越计算得出相当于15 - 20根毛细血管的距离。因此,这些结果支持血清-PIIINP作为急性心肌梗死后心肌局部发生事件的直接标志物的概念。