Kinoshita H, Fujimoto S, Fukae H, Yokota N, Hisanaga S, Nakazato M, Eto T
First and Third Departments of Internal Medicine, Miyazaki Medical College, Miyazaki, Japan.
Nephron. 1999 Feb;81(2):160-4. doi: 10.1159/000045272.
Uroguanylin, a new natriuretic peptide originally isolated from urine, stimulates the membrane guanylate cyclase C receptor. No information, however, is available on the plasma and urine levels of uroguanylin in nephrotic syndrome (NS), the state associated with sodium and water retention. Using a sensitive radioimmunoassay, we measured the plasma and urine concentrations of immunoreactive (ir-)uroguanylin in NS patients and compared them with those of patients with non-nephrotic glomerulonephritis. Plasma ir-uroguanylin, blood pressure and the cardiothoracic ratio were higher, and urine excretion of ir-uroguanylin was lower in the NS patients. Plasma ir-uroguanylin in the NS patients significantly decreased during remission as compared with findings on admission. There was a significant inverse correlation between the concentration of plasma ir-uroguanylin and that of serum total protein or albumin. Moreover, fluid retention in the NS patients was correlated with the changes in plasma ir-uroguanylin between admission and remission, indicative that the plasma concentration increases with the severity of the nephrotic state. Taking into account its potent natriuretic effect, these findings suggest that uroguanylin may function in the pathophysiological mechanism in NS.
尿鸟苷素是一种最初从尿液中分离出的新型利钠肽，可刺激膜鸟苷酸环化酶C受体。然而，关于肾病综合征（NS）（一种与钠水潴留相关的疾病）患者血浆和尿液中尿鸟苷素水平的信息尚无报道。我们采用灵敏的放射免疫分析法测定了NS患者血浆和尿液中免疫反应性（ir-）尿鸟苷素的浓度，并将其与非肾病性肾小球肾炎患者的浓度进行比较。NS患者血浆ir-尿鸟苷素、血压和心胸比更高，而ir-尿鸟苷素的尿排泄量更低。与入院时相比，NS患者缓解期血浆ir-尿鸟苷素显著降低。血浆ir-尿鸟苷素浓度与血清总蛋白或白蛋白浓度之间存在显著负相关。此外，NS患者的液体潴留与入院至缓解期血浆ir-尿鸟苷素的变化相关，表明血浆浓度随肾病状态的严重程度增加。考虑到其强大的利钠作用，这些发现提示尿鸟苷素可能在NS的病理生理机制中发挥作用。
