THE VALUES OF THE SYSTEM OF ARTERIAL NATRIURETIC PEPTIDES IN PATHOGENESIS OF HEMORRAGIC FEVER WITH RENAL SYNDROME

THE AIM of the investigation to evaluate the role of the system of arterial natriuretic peptides in pathogenesis of hemorrhagic fever with renal syndrome (HFRS). PATIENTS AND METHODS. The investigated group included 32 male patients of the age of 16 to 56 years old with severe and moderately severe flow of HFRS without concomitant renal pathology, cardiac and endocrine system. The control group included 12 patients and correlated with the observed group by gender, age and medical history. The concentration of natriuretic peptide 1-28 (ANP 1-28) in blood was determined by immunoferment method with the Peninsula (USA) test system after previous extraction. For the determination of the amount of N-terminal arterial natriuretic propeptide 1-98 (NT-proASP 1-98) in blood we used immunoferment kit EIA for NT-proANP Biomedica (Austria). The statistic evaluation was made with the use of the standard kit of programs Statistica 7,0. We used median, percentile, maximal and minimal values of the data, Mann –Whitney method, the Spearman rank correlation method. RESULTS. During oliguremic, polyuremic and early reconvalescent period in patients with severe form of HFRS was noticed a statistically significant decrease in the concentration of ANP 1-28 in comparison with the control group. In patients with moderate flow of HFRS in polyuremic and early reconvalescent period the concentration for this peptide is significantly lower than in control group. The minimal values of ANP 1-28 was registered in polyuremic period of the disease. In patients with the moderately severe form of the HFRS is noted statistically significant increase of the prohormone level in plasma only in polyuremic period. The maximal values of NT-proANP 1-98 wereregistered in polyuremic period of the disease. CONCLUSION. In patients with HFRS in noted the decrease in concentration of ANP 1-28 in blood, with the most expression in polyuremic period of the desease, and the increase of the level of NT-proANP 1-98 with the maximal values in polyuremic period of HFRS.

1. Kangawa K, Matsuo H. Purification and complete amino acid sequence of a-human atrial natriuretic peptide (a-hANP). Biochem Biophys Res Commun 1984; 118 (1): 131-139

2. Wilkins MR, Redondo J, Brown LA. The natriuretic peptide family. Lancet 1997; 349 (9061): 1307-1310

3. Clerico A, Iervasi G, Del Ry S, Giannessi D. Immunoassay methods for the measurement of natriuretic cardiac hormones (ANP, BNP, and related peptides) in humans. J Clin Ligand Assay 1999; 22 (4): 194-204

4. Clerico A, Emdin M. Diagnostic accuracy and prognostic relevance of the measurement of cardiac natriuretic peptides: A Review. Clin Chem 2004; 50 (1): 33-50

5. Зеленский АИ, Ковальский ГС, Константинов АА. Геморрагическая лихорадка с почечным синдромом на Дальнем Востоке СССР. Хабаровск, 1979; 30-31

6. Цончев Ив. Поражения почек при некоторых инфекционных заболеваниях. В: Болезни почек. Г. Маждраков, Н. Попов, ред. Медицина и физкультура 1976; 725-728

7. Ogawa Y, Itoh H, Nakao K. Molecular biology and biochemistry of natriuretic peptide family. Clin Exp Pharmacol Physiol 1995; 22 (1): 49-53