Modulation of Gold Nanorod Growth via the Proteolysis of Dithiol Peptides for Enzymatic Biomarker Detection

Gold nanorods possess optical properties that are tunable and highly sensitive to variations in their aspect ratio (length/width). Therefore, the development of a sensing platform where the gold nanorod morphology (i.e., aspect ratio) is modulated in response to an analyte holds promise in achieving ultralow detection limits. Here, we use a dithiol peptide as an enzyme substrate during nanorod growth. The sensing mechanism is enabled by the substrate design, where the dithiol peptide contains an enzyme cleavage site in-between cysteine amino acids. When cleaved, the peptide dramatically impacts gold nanorod growth and the resulting optical properties. We demonstrate that the optical response can be correlated with enzyme concentration and achieve a 45 pM limit of detection. Furthermore, we extend this sensing platform to colorimetrically detect tumor-associated inhibitors in a biologically relevant medium. Overall, these results present a subnanomolar method to detect proteases that are critical biomarkers found in cancers, infectious diseases, and inflammatory disorders.

Effect of urinary protease inhibitor (ulinastatin) on cardiopulmonary bypass: a meta-analysis for China and Japan

OBJECTIVES

A meta-analysis was conducted to investigate the effects of ulinastatin treatment on adult patients undergoing cardiac surgery under cardiopulmonary bypass (CPB).

METHODS

Seven electronic databases were searched for reports of randomized, controlled trials conducted up to February 2014 in which patients undergoing cardiac surgery with CPB were administered ulinastatin in the perioperative period.

RESULTS

Fifty-two studies with 2025 patients were retained for analysis. The results showed that the ulinastatin can attenuate the plasma levels of pro-inflammatory cytokines and enhance the anti-inflammatory cytokine levels in patients undergoing cardiac surgery with CPB. Meanwhile, the ulinastatin had a significant beneficial effect on myocardial injury. The mean differences (MD) and 95% confidence intervals (95% CI) of biochemical markers were -63.54 (-79.36, -47.72) for lactate dehydrogenase, -224.99 (-304.83, -145.14) for creatine kinase, -8.75 (-14.23, -3.28) for creatine kinase-MB, and -0.14 (-0.20, -0.09] for troponin I (all P<0.01). However, neither hemodynamics nor cardiac function improved significantly, except that the MD and 95% CI of mean arterial pressure were 2.50 (0.19, 4.80) (P = 0.03). There were no statistically significant differences in the use of inotropes, postoperative bleeding, postoperative complications, the intensive care unit (ICU) stay, and the hospital stay; however, the frequency of auto resuscitation increased significantly (OR 1.98, 95%CI 1.19 to 3.30, P<0.01), the duration of intubation (MD -1.58, 95%CI -2.84 to -0.32, P<0.01) and the duration of mechanical ventilation (MD -3.29, 95%CI -4.41 to -2.17, P<0.01) shortened significantly in patients who were treated with ulinastatin.

CONCLUSIONS

Ulinastatin can reduce the plasma levels of pro-inflammatory cytokines and elevate anti-inflammatory cytokine in patients from China and Japan undergoing cardiac surgery with CPB. Ulinastatin treatment may have protective effects on myocardial injury, and can increase the frequency of auto resuscitation, shorten the duration of intubation and mechanical ventilation.

Proteomic analysis of pancreatic secretory trypsin inhibitor/tumor-associated trypsin inhibitor from urine of patients with pancreatitis or prostate cancer

The development of proteomic methods, especially mass spectrometry, has brought new possibilities to tumor marker research. Pancreatic secretory trypsin inhibitor (PSTI), a common known biomarker for various malignancies, occurs on genetic variants that we are able to detect at the protein level with proteomic techniques using immunoaffinity capture prior to liquid chromatography-mass spectrometry (LC-MS). We also show that PSTI can be detected in urine from cancer patients using a two-step peptide enrichment technique and LC-MS. These results show that tumor-associated peptides can be detected in urine by proteomic techniques.

Immunological evaluation of urinary trypsin inhibitors in blood and urine: role of N- & O-linked glycoproteins

Urinary trypsin inhibitors (uTi) suppress serine proteases during inflammation. After liberation from proinhibitors (P-alpha-I and I-alpha-I) by the white blood cell (WBC) response, uTi readily pass through the kidneys into urine. A key uTi, bikunin, is attached to O-linked and N-linked glycoconjugates. Recently, uTi inhibitors, called uristatins, were found to lack the O-linked glycoconjugates. Monoclonal antibodies were produced using purified uristatin and screened for binding differences to uristatin, bikunin, P-alpha-I, and I-alpha-I. Antibody-binding patterns were characterized using immunoaffinity binding onto protein-chip surfaces and analysis by Surface Enhanced Laser Desorption/Ionization mass spectrometry (SELDI), using specimens from patients and from purified uTi standards. Antibodies were developed and used in an enzyme-linked immunosorbent assay (ELISA) method for uTi measurement in urine and plasma specimens. ELISA was performed on specimens from normal, presumed healthy, controls and from patients who had been screened for inflammation using a high sensitivity C-reactive protein (CRP) test and a complete blood count (CBC). Polyclonal antibody against uTi showed cross-reactivity with the Tamm-Horsfall protein (THP) and with proinhibitors. Screening of anti-uTi monoclonal antibodies (Mab) revealed antibodies that did not cross-react with either of the above, thus providing a tool to measure both uristatin and bikunin in urine with Mab 3G5 and in plasma with Mab 5D11. The monoclonal antibody 5D11 cross-reacts with specific N-linked glycoconjugates of uristatin present in plasma. In ca 96% of healthy adults, uTi were present at <12 mg/l in urine and <4 mg/l in plasma. We also found that patients with an inflammation and a CRP of >2.0 mg/l had higher urinary concentrations of uTi than the control population in every subject. Free uristatin and bikunin pass readily into urine and are primarily bound to heavy chains that constitute the proinhibitor form in plasma.

Pathophysiology and diagnostic value of urinary trypsin inhibitors

Inflammation is an important indicator of tissue injury. In the acute form, there is usually accumulation of fluids and plasma components in the affected tissues. Platelet activation and the appearance in blood of abnormally increased numbers of polymorphonucleocytes, lymphocytes, plasma cells and macrophages usually occur. Infectious disorders such as sepsis, meningitis, respiratory infection, urinary tract infection, viral infection, and bacterial infection usually induce an inflammatory response. Chronic inflammation is often associated with diabetes mellitus, acute myocardial infarction, coronary artery disease, kidney diseases, and certain auto-immune disorders, such as rheumatoid arthritis, organ failures and other disorders with an inflammatory component or etiology. The disorder may occur before inflammation is apparent. Markers of inflammation such as C-reactive protein (CRP) and urinary trypsin inhibitors have changed our appraisal of acute events such as myocardial infarction; the infarct may be a response to acute infection and (or) inflammation. We describe here the pathophysiology of an anti-inflammatory agent termed urinary trypsin inhibitor (uTi). It is an important anti-inflammatory substance that is present in urine, blood and all organs. We also describe the anti-inflammatory agent bikunin, a selective inhibitor of serine proteases. The latter are important in modulating inflammatory events and even shutting them down.

Development of an ELISA Test for Determination of the Urinary Trypsin Inhibitor: Analytical Performance and Applications

Increased urinary excretion of urinary trypsin inhibitor (UTI) has been reported in various inflammatory conditions and in Alzheimer's subjects, but its diagnostic potential remains to be elucidated. A reliable and specific enzyme-linked immunosorbent assay (ELISA) test for the determination of the UTI in human urine was developed. This assay was performed using 96-well microtiter plates. The plate surface is coated with an anti-UTI polyclonal antibody, the urine sample was added in a dilution range, and the detection was achieved using the enzyme-conjugated antibody. The assay was quantified by the build-up of colored product upon the addition of the substrate. Recoveries were 93%, and the intra- and inter-assay CVs were 4.25% and 21%, respectively. The ELISA showed parallelism of standard and urine samples and no significant interference by the biological matrix. The usefulness of the assay has been demonstrated by applying it to urine samples from Alzheimer's disease patients, and comparing with negative controls. UTI urinary levels are significantly increased in Alzheimer's subjects.

Urinary trypsin inhibitor levels in the urine of patients with haematological malignancies

The urinary trypsin inhibitor (UTI) levels in the urine of patients with various haematological malignancies were determined, using automated latex agglutination immunoturbidimetry. The mean UTI levels in urine in acute non-lymphocytic leukaemia, myelodysplastic syndrome, non-Hodgkin's lymphoma, and multiple myeloma groups were significantly elevated, compared with the normal control group. It was found that the UTI level in urine changed from an elevated value to a normal value with haematological improvement by chemotherapy in a patient with myelodysplastic syndrome included in a previous study. These results suggest tha

[Comparison of the trypsin inhibitor activity in urine of donors and patients with kidney diseases]

The general and acid-stable activities, i.e. anti-tryptic activity (ATA) and anti-chemotryptic activity (ACTA), of a trypsin inhibiter in the urine (TIU) were determined for patients and donors. A lack of reliable differences between the general and acid-stable activities in donors and in patients with nephritis is indicative of that TIU is the main inhibiter of trypsin in human urine. A correlation degree between the general ATA and ACTA (r > 0.7) means that the two-domain inhibiter form is excreted into the urine. A comparison between the general and acid-stable ATAs suggests the presence of other trypsin inhibiters in the urine of patients.

Combination assay of urinary free L-fucose and trypsin inhibitor may be useful indicators of disease activity in patients with hematologic malignancies

L-Fucose is a monosaccharide located at the non-reducing ends of sugar chains of glycoconjugates. Urinary L-fucose (U-FC) is excreted as free L-fucose, and clinically useful as a tumor marker of digestive organ cancers. We evaluated the clinical usefulness of U-FC levels in patients with various hematologic malignancies because U-FC for hematologic malignancies has only rarely been described. The mean U-FC levels in the acute nonlymphocytic leukemia (ANLL), myelodysplastic syndromes (MDS) and myeloproliferative disorders (MPD) groups were significantly higher than in the control group (P < 0.05). Recently, we reported that urinary trypsin inhibitor (UTI) levels in patients with ANLL, MDS, non-Hodgkin's lymphoma and multiple myeloma were significantly elevated, compared with those in healthy adult volunteers. Noninvasive combination assays of UTI and U-FC may have a higher accuracy in diagnosis of ANLL and MDS than those of UTI or U-FC alone. UTI and U-FC combination assays, noninvasive for patients, could be expanded as useful indicators in hematologic malignancies.

Kinetics of urinary trypsin inhibitor in patients undergoing partial hepatectomy

BACKGROUND

The kinetics and role of urinary trypsin inhibitor (UTI) in liver surgery are unclear. We investigated the effects of preoperative liver function and the extent of liver resection on postoperative UTI synthesis in the liver after partial hepatectomy.

METHODS

Sixty-one consecutive patients who underwent liver resection were the subjects of the study. Plasma and urine UTI, plasma C reactive protein (CRP) and plasma and urine creatinine were measured perioperatively.

RESULTS

Although the average plasma UTI level did not change significantly, the average urine UTI level per day showed a change similar to that of the average plasma CRP level, reaching a maximum of approximately eight times the preoperative level on the second postoperative day (86,610 +/- 53,109 U/day). The maximum postoperative increase in urine UTI excretion per day (delta-uUTImax) correlated significantly with the maximum increase in CRP and the increase in creatinine clearance. Multiple regression analysis revealed that delta-uUTImax was significantly and positively correlated with the indocyanine green plasma disappearance rate and operation duration, and negatively correlated with the resection rate.

CONCLUSIONS

The postoperative urine UTI level may reflect preoperative liver function and the extent of liver resection after partial hepatectomy.

Urinary excretion of Bowman-Birk inhibitor in humans after soy consumption as determined by a monoclonal antibody-based immunoassay

The Bowman-Birk inhibitor (BBI) found in soybeans is a serine protease inhibitor with anticarcinogenic activity. In the present study, an ELISA for BBI was developed with the use of a monoclonal antibody against a reduced form of BBI. This newly developed ELISA method was used to measure the urinary levels of BBI metabolites in nine human subjects after consumption of 36-oz or 60-oz soymilk (containing 105 or 175 mg of BBI) at two time points 36 h apart. The results demonstrate that urinary BBI excretion rates peaked within 6 h and decreased to baseline levels within 12-24 h after soymilk ingestion. The changes in BBI:creatinine ratios in urine closely paralleled the changes in urinary BBI excretion rates after soymilk consumption. These data suggest that BBI ingested p.o. is absorbed and could be bioavailable for cancer chemoprevention in other organs in addition to those in the gastrointestinal tract.

[Urinary trypsin inhibitor in pregnant women with normal and pathological course of pregnancy]

Urinary trypin inhibitor concentration (UTI) was measured by Fritz and all method in the groups of women: non-pregnant (I), pregnant (II), in pregnancy complicated by EPH-gestosis (III) and in the prolongated pregnancy (IV). Furthermore, in the urine from the investigated group the index protein/creatinine was established. There was noticed the statistically significant increase in the UTI concentration in II, III, IV groups comparing to the non-pregnant group--I, and the increase in UTI in III and IV group in comparison to group II. The UTI measurement in the pregnant women connected with the index protein/creatinine could be significant for diagnosing of the pathology of pregnancy.

[Supplement of ulinastatin on renal function after cardiopulmonary bypass]

The effects of Miraclid (ulinastatin) on renal tubular function after open thorax surgery under cardiopulmonary bypass were investigated. On the 3rd day after open thorax surgery, which had lasted more than 127 min under cardiopulmonary bypass, the levels of urinary ulinastatin in the Miraclid group and control (without Miraclid) were 170 IU.mg Cr-1 and 95 IU.mg Cr-1, respectively. In the Miraclid group, 300,000 units.day-1 of Miraclid was administrated for three postoperative days. N-acetyl-beta-d-glucosaminidase in urine as a marker of tubular function rose significantly on the seventh postoperative day in the control group but not in patients with Miraclid group. These data suggested that Miraclid 300,000 units.day-1 was needed to protect renal tubular function and more than that dose was needed to prevent the deterioration of renal function after open thorax surgery after cardiopulmonary bypass lasting more than 127 min.

Detectable concentrations of urinary trypsin inhibitor in cerebrospinal fluid

Urinary trypsin inhibitor (UTI) is a physiological protease inhibitor produced in the liver and excreted into urine. Urinary trypsin inhibitor-like antigen has been demonstrated on glial cells in the brain. This study measured cerebrospinal UTI levels in various conditions. Seven subjects in each of the following groups were studied: patients undergoing spinal anesthesia for minor surgery, spinal anesthesia for cesarean section, removal of meningioma, or at postoperative day 3 after ruptured intracranial aneurysm clipping. Cerebrospinal fluid was collected from a spinal needle, a needle puncturing the sylvian fissure, or a drainage tube from the optical carotid cistern. Urine was collected from a urinary catheter. Cerebrospinal and urinary UTI concentrations were measured by radioimmunoassay, and the urinary UTI concentration was divided by urinary creatinine concentration to give the systemic UTI concentration. The cerebrospinal UTI concentration in the brain tumor and postoperative state groups was significantly higher than in the spinal anesthesia and cesarean section groups. The systemic UTI concentration in the cesarean section and postoperative state groups was significantly higher than in the spinal anesthesia and brain tumor groups. The present results demonstrate that UTI can be detected in the cerebrospinal fluid, and suggest that cerebrospinal UTI increases in patients with a brain tumor or inflammation and is not affected by systemic UTI.

Single-dose administration of Bowman-Birk inhibitor concentrate in patients with oral leukoplakia

The Bowman-Birk inhibitor (BBI) is a soybean-derived serine protease inhibitor and a potential cancer chemopreventive agent for humans. In this Phase I clinical trial, BBI concentrate was administered as a single oral dose to 24 subjects with oral leukoplakia. Pharmacokinetics of BBI was analyzed, and subjects were monitored clinically for toxic effects. Subjects received between 25 and 800 chymotrypsin inhibitor units (CIU) of the compound in a dose escalation trial. BBI was taken up rapidly, and a metabolic product of BBI was excreted in the urine within 24-48 h. No clinical or laboratory evidence of toxicity was observed in the study. Protease activity was also measured in buccal cells to evaluate usefulness as a biomarker. Single-dose BBI concentrate administered up to 800 CIU was well tolerated and appeared to be nontoxic. Further investigation in Phase II clinical trials is being done.

Urinary trypsin inhibitor suppresses vascular smooth muscle contraction by inhibition of Ca2+ influx

Urinary trypsin inhibitor (UTI) and its precursor form inter-alpha trypsin inhibitor (ITI) are present in plasma. To determine the action of UTI on blood vessels, we performed isometric vascular muscle contraction tests, microcirculation studies and measurement of cytosolic free Ca2+ in vascular smooth muscle cells. An isometric vascular muscle contraction test showed that the contractions stimulated by endothelin-1 or norepinephrine were suppressed in the presence of UTI, and that the contractions were not inhibited in the presence of ITI. The microcirculation study showed that the contraction of mesenteric arterioles of WKY rats induced by norepinephrine were inhibited by treatment of UTI, and that they did not alter by treatment of ITI. Pre-incubation of UTI, but not ITI, with vascular smooth muscle cells inhibited the increase of cytosolic free Ca2+ induced by endothelin-1 or norepinephrine. Cell-binding study by biotinylated UTI showed that vascular smooth muscle cells have specific binding site for UTI, but not for ITI. We propose that circulating UTI converted from ITI has a regulatory effect on local vascular tone by regulation of Ca2+ influx into smooth muscle cells.

Preventive effect of ritodrine hydrochloride and/or urinary trypsin inhibitor against lipopolysaccharide-induced preterm delivery in mice

BACKGROUND

The purpose of this study was to confirm the preventive effect of ritodrine hydrochloride (ritodrine) alone or ritodrine plus urinary trypsin inhibitor (UTI) in a mouse model of preterm delivery.

METHODS

On day 17 of pregnancy, female C3H/HeN mice impregnated by male B6D2F1 mice were given two intraperitoneal injections of lipopolysaccharide (LPS) (50 micrograms/kg) at a 3-hour interval, which induced a 100% incidence of preterm delivery within 25 hours of the second dose. Ritodrine (1, 3, or 10 mg/kg, p.o.), UTI (25 X 10(4) units/kg, i.p.), ritodrine (3 mg/kg, p.o.) plus UTI (25 x 10(4) units/kg, i.p.), distilled water (10 ml/kg, p.o.), or distilled water (10 mg/kg, p.o.) plus saline solution (10 ml/kg, i.p.) were administered to the pregnant animals 10 times at 1-hour intervals from 8:00 AM to 5:00 PM on day 18 of pregnancy. In addition, the preventive effect of ritodrine, UTI, or ritodrine plus UTI was examined on LPS-induced contraction of uterine muscle strips isolated from pregnant mice on day 17 of gestation.

RESULTS

The incidence of preterm delivery decreased significantly in a dose-dependent fashion with ritodrine treatment, and there was a significant and synergistic decrease after combined treatment with ritodrine plus UTI. The in vitro uterine contraction induced by LPS was significantly suppressed by both ritodrine and UTI.

CONCLUSIONS

Combination therapy with ritodrine plus UTI may be helpful for preventing preterm delivery in humans without the cardiovascular side effects that often accompany treatment with ritodrine alone.

Inhibition of neutrophil elastase-induced interleukin-8 gene expression by urinary trypsin inhibitor in human bronchial epithelial cells

BACKGROUND

Urinary trypsin inhibitor (UTI), a potential inhibitor for proteinases including neutrophil elastase (NE), trypsin, plasmin, cathepsin B and H has been used for the treatment of lung diseases with the absence of side effects in Japan.

METHODS

In this study, we investigated the inhibitory effects of UTI on both purified NE and NE activities present in bronchoalveolar fluids from patients with chronic bronchitis. We also investigated the inhibitory capacity of UTI with regard to NE-induced interleukin-8 gene expression in human bronchial epithelial cells by Northern analyses.

RESULTS

UTI inhibited NE activities in bronchoalveolar lavage fluid from patients with chronic bronchitis and of the purified enzyme. In addition, UTI inhibited NE-induced interleukin-8 gene expression and protein secretion in a human bronchial epithelial cell line.

CONCLUSIONS

Our results suggest that UTI is applicable to patients with a variety inflammatory lung diseases in which NE plays a pivotal role.

Ability of intrauterine bacterial lipopolysaccharide to cause in situ uterine contractions in pregnant rabbits

BACKGROUND

To investigate the ability of bacterial lipopolysaccharide delivered by the intra-uterine route to cause uterine contractions in rabbits, and to assess the suppressive effect of urinary trypsin inhibitor on them.

METHODS

Both pregnant and non-pregnant rabbits were chronically implanted with a force-transducer to make it possible to record isometric uterine contractions under unanesthetized and unrestrained conditions. Lipopolysaccharide (10 micrograms/animal) was administered via a catheter to their uteri; and then, after confirmation of lipopolysaccharide-induced uterine contractions, urinary trypsin inhibitor (3,000 or 10,000 units/animal/time) or saline solution was injected through the catheter, 5 times for pregnant animals or 3 times for non-pregnant animals at 1-hour intervals in both cases. Their uterine contractions were continuously recorded for 3 to 5 hours. Effects of lipopolysaccharide (10 micrograms/ml) and urinary trypsin inhibitor (100 and 1,000 units/ml) on the contraction of isolated uteri from pregnant mice were also measured, as was their production of prostaglandin E2 and prostaglandin F2 alpha by an enzyme immunoassay method.

RESULTS

Lipopolysaccharide augmented the in situ uterine contractions in both pregnant and non-pregnant rabbits, as well as the in vitro contractions of isolated uteri from pregnant mice. Lipopolysaccharide also increased the uterine prostaglandin production. Urinary trypsin inhibitor inhibited significantly the lipopolysaccharide-induced uterine contractions and the prostaglandin production.

CONCLUSIONS

Lipopolysaccharide enhanced uterine contractions through, at least partly, a direct mechanism via uterine prostaglandin production, which action could explain the onset of preterm delivery due to intrauterine bacterial infection. As urinary trypsin inhibitor suppressed the lipopolysaccharide-induced uterine contractions, this inhibitor may be a hopeful candidate of a drug for prevention of preterm delivery.

Further evidence for the mitogenic action of urinary trypsin inhibitor

We have previously shown that urinary trypsin inhibitor (UTI), also known and bikunin, was mitogenic for human fibroblasts at low concentrations, and growth-inhibitory at higher concentrations, and have identified high- and low-affinity cellular binding sites for this protein. We have now investigated fibroblast proteins which interact with bikunin. Bikunin binds to proteins of about 50K and 250K. The simplest interpretation, is that the 50K protein may be a proteinase which is also the low-affinity bikunin binding site, involved in growth inhibition, and that the larger protein may be responsible for the mitogenic response to bikunin. Inhibitors of intracellular calcium mobilisation also inhibit the mitogenic response to bikunin, and by the measurement of the efflux of pre-loaded 45Ca2+, bikunin at mitogenic concentrations can be shown to stimulate calcium mobilization.

Identification of uronic-acid-rich protein as urinary bikunin, the light chain of inter-alpha-inhibitor

Uronic-acid-rich protein (UAP) is a urinary glycoprotein that inhibits calcium oxalate crystallization in vitro. It shows a structural similarity to bikunin, a component of inter-alpha-inhibitor (IalphaI) known for its inhibition of the action of many serine proteinases like trypsin and chymotrypsin. To clarify the relationship between these macromolecules, UAP, IalphaI, urinary bikunin, and plasma bikunin were purified and studied. Their calcium oxalate crystallization inhibitory activity was assayed before and after treatment with chondroitinase AC and pronase. Their molecular mass was determined by using SDS/PAGE before and after these treatments. Polyclonal bikunin antibody was used on Western blots for immunological identification. The partial amino acid sequence of UAP before and after chondroitinase treatment was determined. Also, the antitryptic activity of UAP was measured and compared to that of bikunin, which is responsible for the antiprotease activity of IalphaI. UAP exhibited a strong calcium oxalate crystallization inhibitory activity. IalphaI and both bikunins were less inhibitory. Chondroitinase AC had no effect on inhibitory activity of these proteins even when their molecular mass changed. However, after pronase treatment, the inhibitory activity of both bikunins and UAP was completely destroyed. The antitryptic activity of UAP was found to be 0.78 U/mg which is lower than that of bikunin which is about 1.9 U/mg. On Western blotting, bikunin antibody immunoreacted with UAP and both urinary and plasma bikunins. Partial amino acid sequence confirmed the identity of UAP as urinary bikunin.

Increased urinary trypsin-inhibitory activity in mercuric chloride induced nephrotoxicity in Wistar rats

The relationship between trypsin-inhibitory activity (TIA) and the nephrotoxic effects of mercuric chloride (HgCl2)--as illustrated by proteinuria and by a drop in the glomerular filtration rate (GFR) measured by creatinine clearance test (CCT)--was investigated in Wistar rats. HgCl2, 150 or 250 micrograms/100 g BW per day was injected intraperitoneally three times a week for 2 weeks. Both groups showed a significant degree of proteinuria and urinary TIA. Group B (250 micrograms HgCl2/100 g BW) displayed a greater drop in GFR than group A (150 micrograms HgCl2/100 g BW). The urinary TIA was significantly correlated with proteinuria (group A: r = 0.87, group B: r = 0.84), but it was also significantly inversely correlated with the CCT (A: r = -0.96; B: r = -0.88).

IN CONCLUSION

these results suggest that increased urinary TIA may be involved in and indicative of the pathogenesis of mercuric chloride induced nephrotoxicity.

[Postoperative urinary ulinastatin secretion and renal function in hepatectomized patients with and without liver cirrhosis]

We compared ulinastatin secretion into urine with renal function during postoperative period in three groups, hepatectomized group with liver cirrhosis (LC(+), n = 7), hepatectomized group without liver cirrhosis (LC(-), n = 4) and subtotal gastrectomized group with normal liver function (GR, n = 7). In LC(+) group, N-acetyl-beta-D-glucosaminidase (NAG) increased above normal upper limit throughout the postoperative period. Ulinastatin (UTI) also increased but the increase was not remarkable. In LC(-) group, NAG increase but not significantly compared with the preoperative value. UTI increased from 5.8 +/- 3.0 IU.mg x Cr-1 to 30.8 +/- 16.6 IU.mg x Cr-1 and 39.9 +/- 9.0 IU. mg x Cr-1 on the 1st and 3rd postoperative day respectively. In GR group, there was no change in NAG value. UTI on the 3rd postoperative day increased significantly (from 10.0 +/- 7.7 to 75.4 +/- 39.0 IU.mg x Cr-1). A small urinary secretion of UTI and increased NAG during postoperative period in LC(+) group suggest that UTI might play an important role in postoperative renal dysfunction in patients with liver cirrhosis.

Urinary trypsin inhibitor may have a protective effect on endothelial cells in preeclampsia

Urinary trypsin inhibitor is a glycoprotein which has an inhibitory effect on many enzymes, especially neutrophil elastase. The concentration of urinary trypsin inhibitor in serum (maternal and fetal), urine and amniotic fluid was measured in 20 cases of preeclampsia and compared with levels in normal pregnancy. Urinary trypsin inhibitor levels were significantly increased in the maternal and fetal serum of preeclamptic patients compared to normal pregnancy (p < 0.0001), as well as in urine and amniotic fluid of the same patients. Relative fluorescence release of a calcium chelating agent (fura-2) from human umbilical vein endothelial cell cultures was significantly increased by preeclamptic serum compared to serum of normal pregnant women (p < 0.03). After incubation of urinary trypsin inhibitor with the cultures, significant decrease of fura-2 release was observed (p < 0.03). Urinary trypsin inhibitor has an effect on suppression of activated neutrophils, elastase production and may have a protective effect on endothelial cells.

Charge isomers of urinary bikunin (trypsin inhibitor)

It was observed that the purified urinary bikunin (trypsin inhibitor) consisted of four major isomers with different electric charges which could be separated by HPLC using a Mono Q column. These isomers revealed the same antitrypsin activity and did not show any differences in the apparent molecular weight by SDS-PAGE, amino-acid composition, N-terminal amino-acid sequence (1-40) and C-terminal amino acid (Leu). The contents of sialic acid and uronic acid were also identical among these isomers. However, analysis of chondroitin sulfate revealed all the glycosaminoglycan chains of these isomers were undersulfated, comprising nonsulfated and 4-sulfated disaccharide units, and 4-sulfated disaccharide unit ratio varied among these isomers. After the chondroitin ABC lyase digestion, all the isomers were eluted at the same position on a Mono Q column chromatography. These results indicated that charge isomers of urinary bikunin was attributed to the difference on sulfation ratio in a glycosaminoglycan chain.

[Value of the assay of protein SAA and urinary antitrypsin activity in osteoarticular infections]

Erythrocyte sedimentation rate is normal in 20% to 25% of patients with discitis due to common pathogens. We evaluated serum amyloid A (SAA) protein and urinary trypsin inhibitory activity in osteoarticular infections comparatively with erythrocyte sedimentation rate and serum C-reactive protein in 20 patients including 14 with discitis due to common pathogens and 6 with septic arthritis. Assays were performed on D0, D8, D15, D30, and D60 after initiation of antimicrobial therapy. On D0, all four markers were significantly higher in patients with septic arthritis than in patients with discitis. C-reactive protein levels exhibited the fastest kinetics with a return to normal values within 15 days in both conditions. Urinary trypsin inhibitory activity was only slightly elevated in patients with discitis and returned to normal within 30 days in both conditions. Serum amyloid A levels required 30 to 60 days to return to normal. Erythrocyte sedimentation rate exhibited the slowest kinetics, with normal values being achieved only after 60 days. Although simple, rapid, and inexpensive, urinary trypsin inhibitory activity determination exhibits poor sensitivity. Serum amyloid A assay is not routinely available but may be a valuable parameter for monitoring patients whose erythrocyte sedimentation rate and C-reactive protein level are normal (as in 2 of our patients with discitis).

Structural analysis of a low-sulfated chondroitin sulfate chain in human urinary trypsin inhibitor

The low-sulfated chondroitin 4-sulfate(LSC) chain from human urinary trypsin inhibitor was purified and the structure was characterized. After hyaluronidase SD digestion of LSC, an oligosaccharide which contains the linkage region could be obtained. The structure of oligosaccharide was analyzed by HPLC and 500 MHz 1H-NMR spectroscopy. The analytical results revealed that 4-O-sulfo GalNAc residues were located in the neighborhood of the linkage region.

[A new method of isolating acid-stable trypsin inhibitor from human urine]

A novel procedure for isolation of an acid-resistant trypsin inhibitor from human urine (UTI) is described. The method is based on the use of immobilized on an insoluble matrix monoclonal antibodies specific for the given inhibitor. The use of Immotin (which represents an immobilized on Sepharose 4B UTI) as precolumn during affinity chromatography makes it possible to significantly prolong the immunoadsorbent life and to increase the inhibitor yield up to 92% of its original content in the urine. The preparation obtained with the use of an immunoadsorbent contains predominantly the native form of the inhibitor whose molecular mass is about 44 kDa.

Assessment of the clinical value of urinary trypsin inhibitory activity in elderly people

To assess the clinical value of urinary trypsin inhibitory activity (UTIA) in elderly people, a prospective study was carried out over 4 months in our internal medicine department. Two hundred and forty-three patients of more than 60 years of age were included. A positive correlation was observed between UTIA and serum creatinine (p < 10(-3)). In the population with serum creatinine of less than 133 mumol/l (200 patients), UTIA was independent of age, sex and serum creatinine. UTIA was compared with seven serum inflammatory proteins titrated on patient admission. The principal interest of UTIA determination appeared in bacterial infections. UTIA was significantly increased in this group (p < 10(-4)). However, a positive correlation was proved only with C-reactive protein (CRP) (p = 9 x 10(-4)). Nevertheless, CRP appeared to be the best marker of bacterial infectious diseases after receiver operating characteristic curves analysis.

Structural analysis of the N-linked oligosaccharides from human urinary trypsin inhibitor

The N-linked oligosaccharides from human urinary trypsin inhibitor were purified and their structures were investigated by compositional analysis, the two-dimensional sugar map method and 500 MHz 1H-NMR. The results revealed that they were composed of disialosyl, monosialosyl and asialosyl oligosaccharides, which have the common biantennary core structure; Gal1-4GlcNAc1-2Man1-3(Gal1-4GlcNAc1-2Man1-6)M an1-4GlcNAc1-4GlcNAc.

Existence of a human urinary trypsin inhibitor (urinastatin)-like substance in the rat brain

A human urinary trypsin inhibitor, urinastatin (UT)-like immunoreactive substance with trypsin inhibitory activity, was demonstrated in certain brain regions in rats, especially the cerebral cortex, hippocampus and hypothalamus. Although this UT-like substance in the rat brain displayed an N-terminal amino acid sequence similar to that of glyceraldehyde-3-phosphate dehydrogenase (GAPDH), it did not show any GAPDH activity. These results indicate that the UT-like substance in the rat brain is a protein different from GAPDH and indicates a localized distribution within certain brain regions partly related to learning and memory.

Urinary trypsin inhibitory activity for the diagnosis of bacterial infection: a prospective study in 690 patients

OBJECTIVES

During the acute phase response, interleukin-1 induces production of inter-alpha-trypsin inhibitor. The measurement of urinary trypsin inhibitory activity which results from the effects of inter-alpha-trypsin inhibitor degradation products is easy, quick and inexpensive. We conducted a prospective study to investigate its value as a diagnostic tool in comparison with C-reactive protein.

METHODS

Comparisons were made in 690 consecutive patients at admission to a department of internal medicine.

RESULTS

The level of urinary trypsin inhibitory activity was significantly higher in patients with bacterial infection (mean = 123 IU/g creatinine) than in patients with either viral infection (34 IU), cancer (50 IU), elevated erythrocyte sedimentation rate without infection (45 IU), miscellaneous non-inflammatory diseases (27 IU) or in non-organic controls (19 IU) (Dunnet's test, p << 0.01). The receiver operating characteristic curve showed that sensitivity and specificity of urinary trypsin inhibitory activity were higher than those of C-Reactive protein for the diagnosis of bacterial infection. For levels > or = 60 IU, sensitivity was 75% and specificity 89%. Urinary trypsin inhibitory activity levels fell within 2 days in patients treated for acute bacterial infection.

CONCLUSION

Urinary trypsin inhibitory activity could be a useful marker of bacterial infection particularly in patients with fever of unknown origin and/or elevated erythrocyte sedimentation rate.

[Urinary trypsin inhibitor as an acute phase reactant]

Early in this century, trypsin inhibiting activity has already been recognized in patients with acute infection or renal disease. In addition to these, conditions such as coronary thrombosis, surgical operation, artificial fever by heat-killed bacilli, malignancy, leukemia, later stage of normal pregnancy, etc. have been known to cause the elevated excretion of UTI in urine. Typically, maximal excretion of UTI has been observed within one or two days after the onset. It appears that recent studies have overcome the complexity of UTI molecule. Automated measurement of urinary trypsin inhibitor (UTI) in urine sample was carried out by either enzymic or immunologic method. UTI as well as erythrocyte sedimentation rate and C-reactive protein enables us to monitor acute phase response, being confirmed in cases of abdominal surgery.

Biosynthesis of bikunin (urinary trypsin inhibitor) in rat hepatocytes

One of the major sulfated proteins secreted by rat hepatocytes contains a low-sulfated chondroitin sulfate chain and its apparent molecular mass upon sodium dodecyl sulfate/polyacrylamide gel electrophoresis shifts from 40 to 28 kDa upon chondroitinase ABC treatment (E. M. Sjöberg and E. Fries, 1990, Biochem. J. 272, 113-118). These properties suggest that this protein is the rat homologue of the major trypsin inhibitor of human urine which was recently named bikunin. In serum, bikunin occurs mainly as a subunit of the pre-alpha-inhibitor and the inter-alpha-inhibitor; in these proteins it is covalently linked to the other polypeptides through its chondroitin sulfate chain. Bikunin has been shown to be synthesized by liver cells as a 42-kDa precursor, in which it is linked to alpha 1-microglobulin by two basic amino acids. We have isolated bikunin from rat urine and prepared antibodies against it. In rat hepatocytes pulse-labeled with [35S]methionine, these antibodies precipitated a labeled protein of 42 kDa. Upon chase, three different labeled proteins were recognized by the antibodies in the medium: one protein of 40 kDa (free bikunin), one of 125 kDa (presumably pre-alpha-inhibitor), and one greater than 240 kDa (possibly a protein related to the inter-alpha-inhibitor). Pulse-chase experiments with [35S]sulfate showed that these proteins occurred intracellularly as precursors containing alpha 1-microglobulin. These results demonstrate that the completion of the chondroitin sulfate chain and its coupling to other polypeptide chains occur before the cleavage of the alpha 1-microglobulin/bikunin precursor.

Study on proteoglycans having low-sulfated chondroitin 4-sulfate in human urine and serum

State analysis of low-sulfated chondroitin 4-sulfate (LSC) in human urine and serum was performed by the use of high performance liquid chromatography and Western blot analysis. It was revealed that the most amount of LSC in urine is present as urinary trypsin inhibitor and a small amount (about 10% of total LSC) is as an LSC chain. The LSC in serum is mainly present as a proteoglycan such as inter-alpha-trypsin inhibitor (ITI), with a molecular weight of 212 kDa, but a small amount of LSC-proteoglycans having molecular weights of 128 and 38 kDa were also observed on SDS-PAGE. Those two compounds may be fragments of ITI, or one of the compounds (128 kDa) may be pre-alpha-trypsin inhibitor which was found by Enghild et al. (J. Biol. Chem., 264, 15975 (1989)).

Characterization of a trypsin inhibitor from equine urine

A trypsin inhibitor was isolated from pregnant mares' urine by adsorption on bentonite and elution with aqueous pyridine followed by batch DEAE-cellulose treatment and column chromatography. Final purification to an electrophoretically homogenous glycoprotein was achieved by gel permeation chromatography. This equine urinary trypsin inhibitor (E-UTI) is acid- and heat-stable, has a molecular weight of 22 to 23 kDa, an isoelectric point of 4.55, forms a 1:1 molar complex with trypsin and has serine as its N-terminal amino acid. The N-terminal amino acid sequence of this protein is almost identical with that of EI-14, the inhibitor obtained from horse serum by tryptic treatment, except for two extra amino acid residues, Ser-Lys- on the N-terminal end of E-UTI. In its isoelectric point E-UTI differs from EI-14 and the inhibitor from human urine.

Distribution and elimination of intravenously injected urinary trypsin inhibitor

Elimination of human urinary trypsin inhibitor (UTI) after intravenous injection of 125I-labelled UTI was followed by serial plasma and urine samples in three male volunteers. The plasma half-life of 125IUTI during 0-3 h after injection was 33 min and during the following 4 hours the half-life was 2 hours. Free, biologically active inhibitor was found in the urine during the first four hours after injection. Most of the radioactivity in the urine, however, corresponded to free 125I probably released during the degradation of UTI in the kidney. The distribution of UTI was studied after injection of 125IUTI in rats by measurement of radioactivity in excised organs. Fifteen min after the injection 44% of the radioactivity was found in the kidneys and 9% in the liver, implying that the kidneys are the primary site of UTI metabolism.

Establishment of an enzyme-linked immuno-sorbent assay for urinary trypsin inhibitor by using a monoclonal antibody

Monoclonal antibodies against inter-alpha-trypsin-inhibitor (ITI) were produced. One clone showing specificity for urinary trypsin inhibitor (UTI), a proteolytic fragment of ITI, which is excreted into urine, was selected for the establishment of an enzyme-linked immuno-sorbent assay (ELISA). The ELISA for the quantification of UTI was shown to work reproducibly in the range between 0.5 and 10 ng UTI/ml urine. Urines of several patients suffering from different lung diseases were screened for UTI using the established ELISA. Highest UTI levels were found in the urine of patients with lung empyema. A more moderate increase was observed in patients suffering from lung tuberculosis and from secondary and primary lung tumors.

Significance of microbiological and biochemical analyses in empyema thoracis

Following the indifferent results of a retrospective analysis, a prospective study was undertaken to analyse the causative organisms in 51 cases of empyema. Cultures were positive in 44/51 (= 86.3%) cases. 2 bacterial species were recovered for each empyema. The aerobic gram-positive cocci represented the largest group (57%), followed by aerobic gram-negative bacteria (18.6%), anaerobic bacteria (18.6%), and fungi (5.8%). Polymicrobial empyema accounted for 59.1% of the cases. Anaerobic bacteria were cultured from 36.4% of empyema. Anaerobic bacteria were more frequently isolated from pleural effusions than from other specimens. Swabs were found to be of minor value for anaerobics. Analyses of glucose and pH value in pleural effusions have been reported to be useful in differentiating complicated from uncomplicated effusions in cases where the aspirated fluid is not purulent and is negative on gram stain, but clinical as well as radiological findings point to an empyema. Our results have shown that pH-values less than 7.30 and Glucose less than 60 mg/dl were not absolutely specific for empyema. In contrast, PMN-elastase in pleural effusion and HI-30 in urine showed a statistically significant differentiation of empyema from exudates of other origin.

[Development of an immunoenzyme method for the quantitative determination of an acid-stable trypsin inhibitor in urine: use for assessing the severity of glomerulonephritis]

Acid-stable trypsin inhibitor was isolated from urine of healthy persons; its homogeneous preparation was obtained using absorption on chitosan, affinity chromatography on chymotrypsin-Sepharose 4B and gel filtration of Sephadex G-100. Two forms of the inhibitor were produced with Mr = 44,000 and 22,000; yield of the trypsin inhibitor was about 70% of its content in urine. Indirect immunoenzymatic assay was developed for the inhibitor estimation; optimal conditions were chosen for sorption of the inhibitor on polystyrene plates as well as for dilution of rabbit anti-inhibitor blood serum and of goat antibodies to rabbit antibodies and horse radish peroxidase conjugates. The procedure developed was sensitive; 10-20 ng of the inhibitor was detected per a sample. Urine of healthy persons and of patients with latent and nephrotic forms of glomerulonephritis was studied using the test system developed. The results of estimation of the trypsin inhibitor were considered in diagnostics and evaluation of severity of glomerulonephritis.

Human urinary trypsin inhibitor (urinastatin)-like substance in mouse kidney and its relationships to mouse kidney kallikrein

Mouse kidney contains urinastatin (UT)-like immunoreactive substances with trypsin inhibitory activity. Immunohistochemical studies show that these UT-like substances are localized in the same region as kidney kallikrein, i.e. in the distal tubules. Sephadex column chromatography of mouse kidney extract using 0.1M NaCl as the eluent yielded fractions (C.F.) containing both UT-like and kallikrein-like material. In these fractions (C.F.), the removal of UT-like material caused a concomitant decrease in kallikrein-like activity and vice versa. However, when the kidney extract was eluted with an acidic buffer of high ionic strength, the fractions containing both UT-like and kallikrein-like substances were not observed. These results suggest that these two components are intimately bound to one another. The kallikrein activity responded differently to pH, to metal ions (zinc and copper), and to the sodium/potassium ratio, depending on the concomitant presence or absence of UT-like material. These findings suggest that kallikrein activity in kidney tissue is modified by the presence of an UT-like substance.