Procoagulant activity (PCA) in normal human urine was found to be sedimented by centrifugation at X 100,000g. Therefore, studies were done to identify the structures associated with the procoagulant activity. Transmission electron microscopy of the X 100,000g pellet revealed numerous membrane-bound vesicles as well as fibrous material. Filtration of normal urine through a 0.2-micron filter removed more than 90% of the procoagulant activity. Scanning electron microscopy of the filter surface revealed 0.1 to 1.1 micron particles and fibrous material. By centrifugation at pH 3 and 5 the fibrous material and particles were separated. The procoagulant activity remained with the particles in each case. The fibrous material was shown to be Tamm-Horsfall protein by SDS-PAGE and Western blotting using anti-Tamm-Horsfall protein serum. Purified Tamm-Horsfall protein itself was not procoagulant. Therefore, PCA in normal human urine is associated with particles 0.1 to 1.1 micron in diameter which appear to be lipid membranes in various arrangements.

Nitrocellulose blots of normal human plasma proteins separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis were examined for polymeric complexes and fragments of albumin using an immunoperoxidase-labelled mouse monoclonal anti-human albumin antibody. Under reducing conditions, no polymeric complexes were seen. Under non-reducing conditions, polymeric complexes were detected at the following molecular weights: 210 000, 168 000, 147 000, 132 000, and 110 000. These probably represent both homo- and heteropolymers of albumin. Fresh plasma samples were also analyzed by S-200 chromatography with the same results indicating that detection of polymeric complexes was not an artifact of the sodium dodecyl sulfate-polyacrylamide gel electrophoresis technique. In quantitative terms, polymeric complexes constituted 0.3-2.8% of the total albumin present. Fragments of albumin were also seen in normal human plasma with molecular weights of 45 000, 28 000 and 19 000. These fragments probably represent breakdown products of albumin in normal blood, and they constituted less than 2% of the total albumin present.

A sensitive one-dimensional SDS-polyacrylamide gel electrophoretic system was devised whereby the proteins in 1 microliter of unconcentrated urine could be visualized by silver staining over the range 9,000-900,000 molecular weight. Identification of urine proteins was confirmed by Western blotting using peroxidase labelled antibodies. A map of the major proteins visualized in urine from individuals with renal disease was constructed. We conclude that the information available from the simple analysis of proteins according to their size is limited to general conclusions regarding whether proteinuria is likely to be of tubular or glomerular or mixed origin. More specific identification of individual proteins is not feasible because simple protein staining is not sufficiently reliable to identify individual proteins. The reasons for this conclusion are as follows: many proteins in urine migrate with similar apparent molecular weights, some proteins are not visualized by silver staining, and albumin polymeric complexes and fragments can be present at almost any molecular weight. However, one-dimensional SDS-polyacrylamide gel electrophoresis together with Western blotting does provide reliable information which might be clinically and experimentally useful.

Septic shock syndrome is a potentially fatal medical condition that is associated with elevated blood levels of low molecular weight proteins known as cytokines. Adsorption was investigated as a potential method for removing cytokines from blood. Saline with 50 mg/mL human serum albumin (HAS) spiked with pathological concentrations (ng-pg/mL) of radiolabeled cytokine was used to study cytokine adsorption. Adsorption isotherms were linear in the pathological concentration range, with adsorption constants ranging from 33.0 mL/g to 173 mL/g for tumor necrosis factor (TNF-alpha), interleukin-8 (IL-8),interleukin-6 (IL-6), and C3a. Adsorption constants were also determined for interleukin-1alpha (IL-1alpha), IL-1beta, and interferon-gamma (IFN-gamma). The adsorption of cytokines by several different silica adsorbents was investigated. Increased concentrations of NaCl reduced cytokine adsorption, but did not completely eliminate adsorption even at high concentrations, suggesting that adsorption wads not entirely electrostatic in nature. Possible mechanisms of cytokine adsorption are discussed. Data for batch adsorption for TNF-alpha was used to estimate the minimum amount of silica required to treat septic shock. It was concluded that a silica adsorbent has a sufficiently high capacity to be used for hemoperfusion. Adsorption of myoglobin and cytochrome c was also investigated as possible marker proteins for future dynamic adsorption studies in hemoperfusion devices.