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Department of Endocrinology, Christchurch School of Medicine, Christchurch 1, New Zealand
We have recently identified a novel
amino-terminal fragment of pro-brain natriuretic peptide (NT-proBNP) in
the circulation of humans, the concentration of which increases
progressively as the left ventricle fails. To clarify the origins of
NT-proBNP in experimental animals, we have developed an RIA for
NT-proBNP based on residues 52-71 of ovine proBNP-(1
103) and
used it to study cardiac processing, secretion, and metabolism of BNP
in sheep with cardiac overload induced by coronary artery ligation (CAL) or rapid left ventricular pacing (rLVP). The concentration of
NT-proBNP in left atrial plasma extracts drawn from normal control
sheep was threefold that of mature BNP. Size-exclusion and
reverse-phase HPLC analyses of plasma extracts coupled to RIA revealed
a single peak of immunoreactive (ir) NT-proBNP [~8,000 relative
molecular weight
(Mr)],
quite distinct from a single peak of ir-mature BNP (~3,000
Mr). In
contrast, ovine cardiac tissue contained only a single immunoreactive
peak of high-molecular-weight BNP (~11,000
Mr), consistent
in size with proBNP-(1
103). Sampling from the cardiac coronary sinus
in normal control sheep (n = 5) and
sheep with CAL (n = 5) revealed that
the molar ratio of NT-proBNP to mature BNP was similar. There was a
significant gradient of both mature and NT-proBNP across the heart in
normal sheep, whereas after CAL the gradient was significant for mature
BNP only. In both forms of cardiac overload (CAL and rLVP), left atrial
plasma levels of NT-proBNP were significantly increased above normal levels, in contrast with mature BNP levels, which were raised only in
the rLVP group of animals. Blockade of natriuretic peptide metabolism
in sheep with heart failure (induced by rLVP) raised mature BNP levels
threefold but did not affect levels of NT-proBNP. In conclusion, these
studies show that NT-proBNP is formed from proBNP stores during
secretion and, compared with mature BNP, accumulates in plasma because
metabolism of NT-proBNP appears to differ from that of mature BNP.
Although its function, if any, remains unclear, plasma NT-proBNP may
prove to be a sensitive marker of cardiac overload and/or
decompensation.
natriuretic peptide; high-performance liquid chromatography; neutral endopeptidase; cardiac processing
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