Characteristic variation in electrophoretic pattern of plasma proteins in essential hypertension

Evidence for a 12 kDa "Carrier Protein" for Natriuretic Hormone

The search for the elusive Na-K-ATPase-inhibiting natriuretic hormone continues. In this review, evidence is presented that isolating the carrier protein for natriuretic hormone from hypertensive plasma is a necessary first step before splitting off the final hormone. The carrier protein has a molecular weight of 12 kDa while the final hormone has a molecular weight of 408 Da. Both compounds inhibit Na-K-ATPase but the compound containing the carrier protein predominates. The question has been raised as to whether the carrier protein is in actuality proANF, a 17 kDa protein that can be split between a 14 kDa protein (the presumptive proANF) and the 3 kDa ANF.

Pharmacokinetics of drugs in spontaneously or secondary hypertensive rats

1. Spontaneously hypertensive rats (SHRs) and deoxycorticosterone acetate-salt-induced hypertensive rats (DOCA-salt rats) have been developed as animal models for human essential (idiopathic or primary) and secondary hypertensions, respectively. 2. In order to identify pharmacokinetic changes (mainly non-renal clearance, CLNR) in 16-week-old SHRs due to hereditary characteristics and/or neither the hypertensive state itself, we reviewed the pharmacokinetics of drugs in 6- (blood pressure within a normotensive range) and 16-week-old SHRs and 16-week-old DOCA-salt rats compared with respective control rats. 3. We reviewed changes in CLNRs of drugs which are primarily metabolized via hepatic microsomal cytochrome P 450 enzymes (CYPs) based mainly on data from hypertensive rats, and present the data in terms of changes in in vitro hepatic intrinsic clearance (CLint), free fraction in plasma (fp) and hepatic blood flow rate (QH) depending on the hepatic excretion ratios of drugs. In general, changes in the CLNRs of drugs in this category were well-explained by the above-described factors. 4. We also reviewed and discussed the mechanism of urinary excretion of drugs (i.e. glomerular filtration and active renal secretion or reabsorption) in hypertensive rats.

Simultaneous measurement of marinobufagenin, ouabain, and hypertension-associated protein in various disease states

We have previously demonstrated that a 12 kD hypertension-associated protein (HAP) is elevated in essential hypertension and that this protein has the characteristics of natriuresis, inhibition of Na-K-ATPase, displaces 3H-ouabain from binding sites, and is vasoconstrictive in vitro. In the present study, plasma from 101 patients were examined [25 normals (N)age 50, 7 with acute congestive heart failure (CHF), 24 with chronic renal failure (CRF), on dialysis, 5 with idiopathic hyperaldosteronism (PA) and 27 with essential hypertension, untreated (EHT)]. Plasma was extracted with 32% acetonitrile, then analyzed by DELFIA for marinobufagenin and ouabain. In addition, from 32 patients (6 N <50, 6 N >50, 5 CHF, 5 CRF, 6 EHT, and 4 PA) SDS gradient gels were obtained. The 12 kD bands were extracted, analyzed for Na-K-ATPase inhibition, marinobufagenin and ouabain, and compared to 14 kD and 21 kD bands. Marinobufagenin was found to be elevated in CRF, EHT, PA and CHF. Ouabain was increased only in PA. When the relative optical densities of the 12 kD and 21 kD bands were contrasted, CRF, PA, and EHT were found to be increased and CHF to be decreased in the 12 kD band, with no discernible changes in the 21 kD bands. Following extraction of the bands, Na-K-ATPase inhibitory activity measured 38% in 18 pooled 12 kD bands, with essentially no activity found in the 14 kD or 21 kD bands. Thus only the 12 kD HAP band possessed all of the attributes of natriuretic hormone.

Benefit-risk assessment of investigational drugs: current methodology, limitations, and alternative approaches

Development of investigational drugs is a process integrated traditionally into four overlapping phases. The goal is to introduce new therapies to clinical medicine by assessing benefits and risks associated with administering the new drug. Benefit assessment is performed with respect to the disease for which the drug may comprise an effective treatment. In contrast, safety assessment is relatively standardized across many pharmacologic classes of agents. For purposes of benefit-risk assessment, investigational drugs are developed to provide benefit in three major disease categories: acute, episodic, and chronic. Benefit assessment is the major focus of conventional methodologies. Inherent limitations of risk assessment produced by conventional approaches are illustrated by the historical inability to detect toxicities of various drugs until large patient populations have been treated, typically after the drug is marketed. Alternative approaches to overcome these limitations include assessment of safety in studies specifically designed to optimize such evaluation and more extensive safety testing of investigational drugs in patient subgroups at higher risk. Such approaches serve the interest of patients, physicians, and developers by facilitating the development of new therapies by providing a more complete benefit-risk assessment prior to initial marketing of the drug.

Isolation of a plasma protein observed in patients with essential hypertension

In patients with essential hypertension, an additional plasma protein with an apparent molecular weight of 15,000 has been observed by high resolution sodium dodecyl sulphate polyacrylamide gel electrophoresis in the presence of beta-mercaptoethanol. Gel filtration on Sephacryl S-300 superfine revealed a native molecule with a molecular weight of 105,000. After reduction of the disulfide bridges with beta-mercaptoethanol the native molecule is dissociated into two subunits of 45,000 and one of 15,000. The native plasma protein has been purified by a combination of gel filtration on Sephacryl S-300, affinity chromatography on Concanavalin A Sepharose and anion exchange chromatography on DEAE-Sepharose. This protein has been referred to as "hypertension associated protein" (HAP).

Plasma protein changes in primary hypertension in humans and rats

To determine whether plasma protein changes may be associated with primary hypertension, we analyzed plasma proteins from essential hypertensive (EHT) patients and genetically hypertensive rats using two-dimensional electrophoresis. An additional plasma protein, having a molecular weight of 13,000 daltons and an isoelectric point of 4.5, was found in 82% of the patients with borderline or moderate hypertension (n = 29) and in all permanently hypertensive patients (n = 12). This protein was detected in 36% of normotensive (NT) subjects (n = 50). In the latter, the influence of family history, sex, and secondary hypertension were studied. Plasma proteins were also studied in spontaneously hypertensive rats (SHR). In all plasma from young male (n = 10) and female (n = 6) SHR, two additional proteins (molecular weight = 16,000 daltons, pHi = 4.7 and 5.1) were detectable. These plasma proteins were not detectable in male Wistar Kyoto rats (WKY) and in 50% of female WKY, and their frequency was 10% (n = 10) and 0% (n = 3) in normal male WKY and in male WKY rendered hypertensive by methylprednisolone, respectively. We conclude that these alterations of plasma proteins may be considered a biochemical feature of primary hypertension.