Turbucz P, Kiss P, Horkay F, Szokodi I, deChâtel R, Selmeci L, Juhász-Nagy A, Karádi I, Tóth M
Department of Medicine, Semmelweis University, Budapest, Hungary.
J Cardiovasc Pharmacol. 1998;31 Suppl 1:S287-9. doi: 10.1097/00005344-199800001-00080.
We have previously detected in cardiac patients severalfold higher levels of endothelin (ET) in the pericardial fluid (PF) than in the plasma (PL). We postulated that this is due to different activities of neutral endopeptidase (NEP) in the two compartments. With approval of the ethical committee and informed consent by 32 patients (18 men, 14 women, aged 62 +/- 2 years; NYHA II-IV), PF was taken during cardiac surgery. PL samples were obtained on the day of surgery before premedication. ET was measured by radioimmunoassay after extraction (SepPakC18). NEP activity was measured by a microplate-based kinetic enzyme assay over 120 min. PF ET (78 +/- 11 pg/ml) was significantly (p < 0.05) higher than PL ET (3.38 +/- 0.48 pg/ml). The PF/PL ratio was 38 +/- 14, range 7-200. PF ET was inversely related to the NYHA state of the patients, whereas a similar relation was not found with PL ET. PL and PF ET levels did not correlate. In HPLC, the total immunoreactive ET activity co-eluted with the human ET standard. PF NEP activity (2.26 +/- 0.12 U/l) was lower (p < 0.05) than PL NEP (3.62 +/- 0.22 U/I). PL NEP was not different from that of healthy controls (3.28 +/- 0.22 U/L; n = 50). No correlation was found between NEP in either compartment and the NYHA state of the patients. ET concentration and NEP activity did not correlate in PF or PL. We conclude that ET is extremely high in the PF of cardiac patients and that this is not caused by altered NEP activity.
我们之前在心脏病患者中检测到，心包液（PF）中的内皮素（ET）水平比血浆（PL）中的高几倍。我们推测这是由于两个腔室中中性内肽酶（NEP）的活性不同所致。经伦理委员会批准并获得32例患者（18例男性，14例女性，年龄62±2岁；纽约心脏协会II-IV级）的知情同意后，在心脏手术期间采集PF。在手术当天术前用药前采集PL样本。提取后（SepPakC18）通过放射免疫测定法测量ET。通过基于微孔板的动力学酶测定法在120分钟内测量NEP活性。PF ET（78±11 pg/ml）显著高于（p<0.05）PL ET（3.38±0.48 pg/ml）。PF/PL比值为38±14，范围为7-200。PF ET与患者的纽约心脏协会状态呈负相关，而PL ET未发现类似关系。PL和PF ET水平不相关。在高效液相色谱中，总免疫反应性ET活性与人ET标准品共洗脱。PF NEP活性（2.26±0.12 U/l）低于（p<0.05）PL NEP（3.62±0.22 U/I）。PL NEP与健康对照组（3.28±0.22 U/L；n = 50）无差异。两个腔室中的NEP与患者的纽约心脏协会状态之间均未发现相关性。PF或PL中的ET浓度和NEP活性不相关。我们得出结论，心脏病患者的PF中ET极高，这不是由NEP活性改变引起的。
