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Borensztajn DM, Tan CD, de Rijke Y, Hagedoorn NN, Verbruggen SC, Moll HA, Vermont CL. Elevated High-Sensitivity Troponin and NT-proBNP Values in Febrile Children. Pediatr Emerg Care 2024; 40:108-113. [PMID: 38113471 DOI: 10.1097/pec.0000000000003097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
OBJECTIVES The COVID-19 pandemic and subsequent rise of multisystem inflammatory syndrome in children have raised interest in high-sensitivity troponin (hs-TnT) and N-terminal probrain natriuretic peptide (NT-proBNP) because these have been found to be elevated in many cases of multisystem inflammatory syndrome in children. Our aim was to study hs-TnT and NT-proBNP concentrations in febrile children not affected by COVID-19. METHODS We retrospectively measured cardiac markers, hs-TnT, and NT-proBNP in leftover blood samples of febrile children (0-18 years) diagnosed and treated in a single-center emergency department (ED) (N = 67) and pediatric intensive care unit (PICU) (N = 19) that participated in a multicenter, prospective study of infection biomarkers (PERFORM). RESULTS Concentrations of hs-TnT, median 1.8 ng/L (interquartile range [IQR], 0.0-15.1), and NT-proBNP, 194 pg/mL (IQR, 54.9-706), were higher in febrile children than in controls (N = 25, hs-TnT 0.0 [IQR, 0-0]; NT-proBNP 56.3 [IQR, 29.7-109], both P < 0.001), whereas PICU patients had higher concentrations (hs-TnT 15.1 [IQR, 10.3-102] and NT-proBNP 828 [IQR, 657-4712], both P < 0.001) than ED patients (hs-TnT 0 [IQR, 0-7.4] and NT-proBNP 104 [IQR, 39.5-363]). No differences were found between viral and bacterial infections. Highest concentrations were found in children with either comorbidity predisposing to elevated concentrations (eg, chronic cardiac or renal disease) or children with critical illness or multiorgan failure such as those with septic shock. CONCLUSIONS Concentrations of hs-TnT and NT-proBNP are often elevated in febrile children with different causes of fever. Concentrations were higher in children admitted to the PICU than in children attending the ED, and seem to reflect disease severity rather than the underlying cause of fever.
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Affiliation(s)
| | - Chantal D Tan
- From the Department of General Pediatrics, Erasmus MC, Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Yolanda de Rijke
- Department of Clinical Chemistry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Nienke N Hagedoorn
- From the Department of General Pediatrics, Erasmus MC, Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Sascha C Verbruggen
- Intensive Care Unit, Department of Pediatrics and Pediatric Surgery, Erasmus MC - Sophia Children's Hospital, Rotterdam, Netherlands
| | - Henriette A Moll
- From the Department of General Pediatrics, Erasmus MC, Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Clementien L Vermont
- Department of Pediatric Infectious Diseases & Immunology, Erasmus MC Sophia Children's Hospital, Rotterdam, the Netherlands
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2
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Gómez-Guzmán E, Cañete MD, Valle-Martos R, Cañete R, Valle M, Jiménez-Reina L, Caballero-Villarraso J. Short-Term Evaluation of Left Ventricular Mass and Function in Children With Growth Hormone Deficiency After Replacement Treatment. Front Pediatr 2018; 6:174. [PMID: 29971224 PMCID: PMC6018080 DOI: 10.3389/fped.2018.00174] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 05/29/2018] [Indexed: 11/17/2022] Open
Abstract
Background: Our study was designed to assess the effects of GHD on nutritional and metabolic parameters, brain natriuretic peptide (BNP) levels, and left ventricular mass (LVM) in prepubertal children and after short-term GH replacement therapy. Materials and Methods: This prospective study enrolled 81 children. We compared 40 GHD children (16 males and 24 females) to 41 healthy children (control group) (18 males and 23 females). All subjects were at Tanner Stage I (aged 7-11 years). At the baseline, a blood sample was drawn and echocardiographic images were obtained. These tests were repeated on the GHD subjects after 6 months of GH replacement therapy. Body surface, weight, size, blood pressure, heart rate, glucose, insulin, HOMA-IR, HOMA-β, QUICKI, cholesterol, HDLc, LDLc, triglycerides, IGF1, and IGFBP3 were measured. Indexed LVM, diastolic and systolic diameter (dD-sD), diastolic and systolic LV function, isovolumic relaxation time, right ventricle function, and BNP levels were obtained through echocardiography. These parameters were correlated to growth factors. Data were analyzed using Student's t-test or U-Mann-Whitney-test and Pearson's correlation, considering p < 0.05 to be significant. Results: Indexed LVM was smaller in GHD patients than in controls, whereas diastolic and systolic functions, BNP, metabolic, and nutritional profiles were similar. After treatment, nutritional and metabolic profiles significantly improved, though diastolic and systolic functions did not seem to have changed. There was a significant increase in LVM. Indexed LVM was similar to that of controls. Significant correlations were obtained between LVM-IGF1 and sD-IGFBP3. Conclusions: GHD in childhood is associated with a lower indexed LVM. In the short-term, GH increases the indexed LVM, while maintaining normal systolic and diastolic functions, BNP, and an improved lipid profile.
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Affiliation(s)
- E Gómez-Guzmán
- Cardiology Unit, Hospital Reina Sofía de Córdoba, Cordova, Spain.,Instituto Maimonides de Investigación Biomédica de Cordoba, Cordova, Spain
| | - M D Cañete
- Instituto Maimonides de Investigación Biomédica de Cordoba, Cordova, Spain
| | | | - R Cañete
- Cardiology Unit, Hospital Reina Sofía de Córdoba, Cordova, Spain.,Instituto Maimonides de Investigación Biomédica de Cordoba, Cordova, Spain
| | - M Valle
- Instituto Maimonides de Investigación Biomédica de Cordoba, Cordova, Spain.,Clinical Analysis Services, Hospital Valle De Los Pedroches, Cordova, Spain
| | - L Jiménez-Reina
- Instituto Maimonides de Investigación Biomédica de Cordoba, Cordova, Spain.,Facultad de Medicina y Enfermería, Universidad de Córdoba, Cordova, Spain
| | - J Caballero-Villarraso
- Instituto Maimonides de Investigación Biomédica de Cordoba, Cordova, Spain.,Clinical Analysis Services, Hospital Valle De Los Pedroches, Cordova, Spain
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Reeves S, Womack C, Lutherer LO, Todd C, Pinkney K, Kasemsri T. What Is High Enough? Elevated NT-pro-BNP in Decompensated Paroxysmal Supraventricular Tachycardia. J Pediatr Intensive Care 2017; 7:49-53. [PMID: 31073468 DOI: 10.1055/s-0037-1603760] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 05/02/2017] [Indexed: 12/26/2022] Open
Abstract
Since the late 1980s, elevated atrial natriuretic peptide (ANP) was considered the cause of brisk diuresis in adult patients with paroxysmal supraventricular tachycardia (PSVT). Pro-brain natriuretic peptide (pro-BNP) and related molecules, e.g., N-terminal pro b-type natriuretic peptide (NT-pro-BNP) are known biomarkers of heart failure in adult patients from many causes with probable relevance in children. Perhaps, pro-BNP or related molecules such as NT-pro-BNP are useful in the management of PSVT in infants, thus hastening treatment in children who may otherwise significantly decompensate. Case series of one infant and two neonates presenting with cardiogenic shock and evidence of heart failure are presented. Cardiac monitoring or electrocardiogram (ECG) confirmed the presence of PSVT. Adenosine was administered resulting in successful chemical cardioversion with each case. Significantly elevated NT-pro-BNP levels correlated with heart failure prior to cardioversion. In each case, patients were discharged home with lower NT-pro-BNP levels and maintenance with a β-blocker. Due to documented relationships between elevated pro-BNP level and heart failure in adults, the authors measured the related biomarker NT-pro-BNP in each case, as the relationship could be similar in pediatric PSVT. Based on our experience with children in acute heart failure from other causes, NT-pro-BNP can increase to potentially extreme levels in infants. It appears to correlate with clinical signs of insufficient cardiac output, such as tachycardia, respiratory distress, and moribund appearance. Indeed, in the case series, extremely high NT-pro-BNP values were obtained when the patients appeared moribund from decompensated PSVT. The question arising from these observations is: At what level of elevated NT-pro-BNP, would patients be identified for cardioversion prior to appearance of other signs and symptoms? For each patient within the case series, NT-pro-BNP levels of approximately 20,000 pg/mL were indicative of decompensated heart failure, which was subsequently confirmed by examination of the patient. Further investigation is needed to determine the clinical significance of NT-pro-BNP and related peptides in pediatric patients with PSVT and intermittent PSVT. However, the possibility exists that an increase in NT-pro-BNP and related peptides could be a biomarker for cardiac decompensation after prolonged or intermittent PSVT, thereby shortening the time of diagnosis and intervention, and hence, potentially preventing morbidity, mortality, and extended hospitalization. Additional evidence-based research would help provide biomarker information during PSVT allowing practitioners to more objectively analyze risks.
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Affiliation(s)
- Shawn Reeves
- Lead Acute Care Pediatric NP, Division of Pediatric Critical Care, Texas Tech University Health Sciences Center, Lubbock, Texas, United States
| | - Clayton Womack
- Acute Care Pediatric NP, Division of Pediatric Critical Care, Texas Tech University Health Sciences Center, Lubbock, Texas, United States
| | - L O Lutherer
- Texas Tech University Health Sciences Center, Clinical Research Institute, Lubbock, Texas, United States
| | - Christopher Todd
- Division of Pediatric Critical Care, Texas Tech University Health Sciences Center, Lubbock, Texas, United States
| | - Kerrie Pinkney
- Division of Pediatric Critical Care, Texas Tech University Health Sciences Center, Lubbock, Texas, United States
| | - Thivakorn Kasemsri
- Division of Pediatric Critical Care, Texas Tech University Health Sciences Center, Lubbock, Texas, United States
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Abman SH, Hansmann G, Archer SL, Ivy DD, Adatia I, Chung WK, Hanna BD, Rosenzweig EB, Raj JU, Cornfield D, Stenmark KR, Steinhorn R, Thébaud B, Fineman JR, Kuehne T, Feinstein JA, Friedberg MK, Earing M, Barst RJ, Keller RL, Kinsella JP, Mullen M, Deterding R, Kulik T, Mallory G, Humpl T, Wessel DL. Pediatric Pulmonary Hypertension: Guidelines From the American Heart Association and American Thoracic Society. Circulation 2015; 132:2037-99. [PMID: 26534956 DOI: 10.1161/cir.0000000000000329] [Citation(s) in RCA: 686] [Impact Index Per Article: 76.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Pulmonary hypertension is associated with diverse cardiac, pulmonary, and systemic diseases in neonates, infants, and older children and contributes to significant morbidity and mortality. However, current approaches to caring for pediatric patients with pulmonary hypertension have been limited by the lack of consensus guidelines from experts in the field. In a joint effort from the American Heart Association and American Thoracic Society, a panel of experienced clinicians and clinician-scientists was assembled to review the current literature and to make recommendations on the diagnosis, evaluation, and treatment of pediatric pulmonary hypertension. This publication presents the results of extensive literature reviews, discussions, and formal scoring of recommendations for the care of children with pulmonary hypertension.
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MESH Headings
- Cardiovascular Agents/therapeutic use
- Child
- Child, Preschool
- Combined Modality Therapy
- Diagnostic Imaging/methods
- Disease Management
- Extracorporeal Membrane Oxygenation
- Genetic Counseling
- Heart Defects, Congenital/complications
- Heart Defects, Congenital/therapy
- Hernias, Diaphragmatic, Congenital/complications
- Hernias, Diaphragmatic, Congenital/therapy
- Humans
- Hypertension, Pulmonary/diagnosis
- Hypertension, Pulmonary/etiology
- Hypertension, Pulmonary/genetics
- Hypertension, Pulmonary/therapy
- Infant
- Infant, Newborn
- Lung/embryology
- Lung Transplantation
- Nitric Oxide/administration & dosage
- Nitric Oxide/therapeutic use
- Oxygen Inhalation Therapy
- Persistent Fetal Circulation Syndrome/diagnosis
- Persistent Fetal Circulation Syndrome/therapy
- Postoperative Complications/therapy
- Respiration, Artificial/adverse effects
- Respiration, Artificial/methods
- Ventilator-Induced Lung Injury/prevention & control
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Fabiansen C, Lykke M, Hother AL, Koch J, Nielsen OB, Hunter I, Goetze JP, Friis H, Thymann T. Cardiac Dysfunction in a Porcine Model of Pediatric Malnutrition. PLoS One 2015; 10:e0140472. [PMID: 26473958 PMCID: PMC4608818 DOI: 10.1371/journal.pone.0140472] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 09/25/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Half a million children die annually of severe acute malnutrition and cardiac dysfunction may contribute to the mortality. However, cardiac function remains poorly examined in cases of severe acute malnutrition. OBJECTIVE To determine malnutrition-induced echocardiographic disturbances and longitudinal changes in plasma pro-atrial natriuretic peptide and cardiac troponin-T in a pediatric porcine model. METHODS AND RESULTS Five-week old piglets (Duroc-x-Danish Landrace-x-Yorkshire) were fed a nutritionally inadequate maize-flour diet to induce malnutrition (MAIZE, n = 12) or a reference diet (AGE-REF, n = 12) for 7 weeks. Outcomes were compared to a weight-matched reference group (WEIGHT-REF, n = 8). Pro-atrial natriuretic peptide and cardiac troponin-T were measured weekly. Plasma pro-atrial natriuretic peptide decreased in both MAIZE and AGE-REF during the first 3 weeks but increased markedly in MAIZE relative to AGE-REF during week 5-7 (p ≤ 0.001). There was overall no difference in plasma cardiac troponin-T between groups. However, further analysis revealed that release of cardiac troponin-T in plasma was more frequent in AGE-REF compared with MAIZE (OR: 4.8; 95%CI: 1.2-19.7; p = 0.03). However, when release occurred, cardiac troponin-T concentration was 6.9-fold higher (95%CI: 3.0-15.9; p < 0.001) in MAIZE compared to AGE-REF. At week 7, the mean body weight in MAIZE was lower than AGE-REF (8.3 vs 32.4 kg, p < 0.001), whereas heart-weight relative to body-weight was similar across the three groups. The myocardial performance index was 86% higher in MAIZE vs AGE-REF (p < 0.001) and 27% higher in MAIZE vs WEIGHT-REF (p = 0.025). CONCLUSIONS Malnutrition associates with cardiac dysfunction in a pediatric porcine model by increased myocardial performance index and pro-atrial natriuretic peptide and it associates with cardiac injury by elevated cardiac troponin-T. Clinical studies are needed to see if the same applies for children suffering from malnutrition.
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Affiliation(s)
- Christian Fabiansen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Mikkel Lykke
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Anne-Louise Hother
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Jørgen Koch
- Department of Clinical Veterinary and Animal Sciences, University of Copenhagen, Frederiksberg, Denmark
| | | | - Ingrid Hunter
- Department of Clinical Biochemistry, Rigshospitalet Copenhagen, Copenhagen, Denmark
| | - Jens P. Goetze
- Department of Clinical Biochemistry, Rigshospitalet Copenhagen, Copenhagen, Denmark
| | - Henrik Friis
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Thomas Thymann
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
- Department of Clinical Veterinary and Animal Sciences, University of Copenhagen, Frederiksberg, Denmark
- * E-mail:
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6
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Afshani N, Schülein S, Biccard BM, Thomas JM. Clinical utility of B-type natriuretic peptide (NP) in pediatric cardiac surgery--a systematic review. Paediatr Anaesth 2015; 25:115-26. [PMID: 24965035 DOI: 10.1111/pan.12467] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/26/2014] [Indexed: 02/04/2023]
Abstract
BACKGROUND NP is a biomarker that has been used in the diagnosis, management, and prognostication of a number of cardiovascular disorders in the pediatric population. The physiological role of this hormone is to allow the myocardium to adapt to stress or strain imposed by a volume and/or pressure load. OBJECTIVE The aim of this study was to determine the utility of preoperative and postoperative NP to predict outcome in pediatric patients undergoing cardiac surgery for structural congenital heart disease. METHOD We conducted a systematic review by searching three electronic databases using the search terms 'paediatric' or 'pediatric' and 'B-type natriuretic peptide'. Twenty peer-reviewed papers were included in the study. RESULTS Preoperative NP levels were associated with the severity of cardiac failure in several studies. Preoperative NPs also correlated with early postoperative outcome measures such as duration of cardiopulmonary bypass, duration of mechanical ventilation, presence of low cardiac output syndrome, length of stay in the intensive care unit and in one study, death. Early (within 24 h) postoperative NPs showed a stronger correlation than preoperative NPs to early postoperative adverse events. CONCLUSION NPs provide a simple, noninvasive and complementary tool to echocardiography that can be used to assist clinicians in the assessment and management of pediatric patients with congenital heart disease in the perioperative period.
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Affiliation(s)
- Nura Afshani
- Department of Anaesthetics, University of Cape Town, Cape Town, South Africa
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Mejia AAS, Simpson KE, Hildebolt CF, Pahl E, Matthews KL, Rainey CA, Canter CE, Jay PY, Johnson MC. Tissue Doppler septal Tei index indicates severity of illness in pediatric patients with congestive heart failure. Pediatr Cardiol 2014; 35:411-8. [PMID: 24061276 PMCID: PMC3944049 DOI: 10.1007/s00246-013-0794-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Accepted: 08/28/2013] [Indexed: 11/30/2022]
Abstract
The Doppler Tei index is an independent predictor of outcomes in adult heart failure. Tissue Doppler imaging (TDI) may be a superior method to measure the Tei index in children because it is less affected by heart rate variability. We hypothesized that the TDI Tei index reflects severity of illness in pediatric heart failure. Twenty-five pediatric heart failure patients were prospectively enrolled. Listing for heart transplantation or death were the outcomes used to define severity of illness. Baseline demographics, brain natriuretic peptide (BNP), and standard echocardiographic and TDI-derived parameters were analyzed to determine outcome indicators. Ten of the 25 patients (40%) were listed for transplantation. There were no deaths. Multivariate analysis combining age, heart rate, standard echocardiographic parameters, and BNP resulted in shortening fraction (p = 0.002) as the best indicator of listing for transplantation (R(2) = 0.32). A second multivariate analysis combining age, heart rate, TDI parameters, and BNP resulted in age (p = 0.03) and septal Tei index (p = 0.03) as the best predictive model (R(2) = 0.36). The area under the receiver operating characteristic (ROC) curve for septal Tei index was 0.84 (95% confidence interval = 0.64-0.96,), and it was comparable with the ROC curve for shortening fraction, p = 0.76. Optimal values of sensitivity (100%) and specificity (60%) were obtained with septal Tei index values >0.51. The TDI septal Tei index is an indicator of disease severity in pediatric heart failure patients and offers potential advantages compared with standard echocardiographic measures of left-ventricular ejection.
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Affiliation(s)
- Aura A Sanchez Mejia
- Department of Pediatrics. Washington University School of Medicine. St Louis Children’s Hospital. St Louis, MO
| | - Kathleen E. Simpson
- Department of Pediatrics. Washington University School of Medicine. St Louis Children’s Hospital. St Louis, MO
| | - Charles F Hildebolt
- Mallinkrodt Institute of Radiology. Washington University School of Medicine. St Louis, MO
| | - Elfriede Pahl
- Department of Pediatrics. Northwestern University Feinberg School of Medicine. Ann & Robert H. Lurie Children’s Hospital of Chicago. Chicago, IL
| | - Kathleen L Matthews
- Department of Pediatrics. Northwestern University Feinberg School of Medicine. Ann & Robert H. Lurie Children’s Hospital of Chicago. Chicago, IL
| | - Cheryl A Rainey
- Department of Pediatrics. Washington University School of Medicine. St Louis Children’s Hospital. St Louis, MO
| | - Charles E Canter
- Department of Pediatrics. Washington University School of Medicine. St Louis Children’s Hospital. St Louis, MO
| | - Patrick Y Jay
- Department of Pediatrics. Washington University School of Medicine. St Louis Children’s Hospital. St Louis, MO
| | - Mark C Johnson
- Department of Pediatrics. Washington University School of Medicine. St Louis Children’s Hospital. St Louis, MO
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Alves RS, Ximenes RM, Jorge ARC, Nascimento NRF, Martins RD, Rabello MM, Hernandes MZ, Toyama DO, Toyama MH, Martins AMC, Havt A, Monteiro HSA. Isolation, homology modeling and renal effects of a C-type natriuretic peptide from the venom of the Brazilian yellow scorpion (Tityus serrulatus). Toxicon 2013; 74:19-26. [PMID: 23911732 DOI: 10.1016/j.toxicon.2013.07.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Revised: 07/09/2013] [Accepted: 07/16/2013] [Indexed: 11/19/2022]
Abstract
Mammalian natriuretic peptides (NPs) have been extensively investigated for use as therapeutic agents in the treatment of cardiovascular diseases. Here, we describe the isolation, sequencing and tridimensional homology modeling of the first C-type natriuretic peptide isolated from scorpion venom. In addition, its effects on the renal function of rats and on the mRNA expression of natriuretic peptide receptors in the kidneys are delineated. Fractionation of Tityus serrulatus venom using chromatographic techniques yielded a peptide with a molecular mass of 2190.64 Da, which exhibited the pattern of disulfide bridges that is characteristic of a C-type NP (TsNP, T. serrulatus Natriuretic Peptide). In the isolated perfused rat kidney assay, treatment with two concentrations of TsNP (0.03 and 0.1 μg/mL) increased the perfusion pressure, glomerular filtration rate and urinary flow. After 60 min of treatment at both concentrations, the percentages of sodium, potassium and chloride transport were decreased, and the urinary cGMP concentration was elevated. Natriuretic peptide receptor-A (NPR-A) mRNA expression was down regulated in the kidneys treated with both concentrations of TsNP, whereas NPR-B, NPR-C and CG-C mRNAs were up regulated at the 0.1 μg/mL concentration. In conclusion, this work describes the isolation and modeling of the first natriuretic peptide isolated from scorpion venom. In addition, examinations of the renal actions of TsNP indicate that its effects may be related to the activation of NPR-B, NPR-C and GC-C.
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Affiliation(s)
- Renata S Alves
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Odontologia e Enfermagem, Universidade Federal do Ceará, Rua Cap. Francisco Pedro 1210, 60430-370 Forteleza, CE, Brazil
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