Blood N-Terminal proBNP as a Potential Indicator of Cardiac Preload in Patients with High Volume Load

Yamanouchi, Satoshi; Kudo, Daisuke; Endo, Tomoyuki; Kitano, Yuka; Shinozawa, Yotaro

doi:10.1620/tjem.221.175

Cited by 21 publications

(18 citation statements)

References 23 publications

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“…As a man-made peptide developed through gene engineering, recombinant human brain natriuretic peptide (rhBNP) is widely used clinically for the treatment of decompensated heart failure (9 including sepsis. BNP level may be a good indicator of cardiac preload in patients with high volume load, and serve as a powerful predictor of mortality in patients with sepsis (10)(11)(12). In our previous studies, it was identified that rhBNP exhibited protective effects on certain organs, including lung (13)(14)(15).…”

Section: Introductionmentioning

confidence: 98%

Recombinant human brain natriuretic peptide attenuates LPS-induced cellular injury in human fetal lung fibroblasts via inhibiting MAPK and NF-κB pathway activation

Song

Zhao

Liu

et al. 2016

Molecular Medicine Reports

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Abstract. Inflammatory responses are vital in lung injury diseases, particularly acute respiratory distress syndrome (ARDS). Recombinant human brain natriuretic peptide (rhBNP) has been shown to exhibit anti-inflammatory effects in vivo in our previous studies. The present study aimed to investigate the mechanisms underlying the anti-inflammatory effects of rhBNP on lipopolysaccharide (LPS)-induced human fetal lung fibroblasts (HFL-1). The results showed that LPS induced a significant increase in the leakage of lactate dehydrogenase and the secretion of interleukin (IL)-1β. Activation of p38, extracellular-signal regulated kinase (ERK) 1/2, c-Jun NH2-terminal kinase (JNK) mitogen-activated protein kinases (MAPK)s, and nuclear factor (NF)-κB in HFL-1 cells was also observed following treatment with LPS. Treatment with rhBNP (0.1 µM) reduced the production of IL-1β at the protein and mRNA levels. Moreover, rhBNP decreased the phosphorylation of p38, ERK1/2 and JNK induced by LPS. However, the JNK inhibitor, SP600125, significantly inhibited LPS-induced IL-1β production. These results indicate that the inhibition of IL-1β by may dependent upon the JNK signaling pathway. The LPS-induced NF-κB activation was also suppressed by rhBNP, and IL-1β production was inhibited by the NF-κB inhibitor. Furthermore, NF-κB activation was attenuated by the JNK inhibitor, indicating that NF-κB activation was dependent on the JNK signaling pathway. The present study suggests that rhBNP exhibits an anti-inflammatory effect on LPS-induced HFL-1 cell injury via the inhibition of MAPK and NF-κB signaling pathways and may exhibit therapeutic potential for acute lung injury and ARDS.

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Section: Introductionmentioning

confidence: 98%

Recombinant human brain natriuretic peptide attenuates LPS-induced cellular injury in human fetal lung fibroblasts via inhibiting MAPK and NF-κB pathway activation

Song

Zhao

Liu

et al. 2016

Molecular Medicine Reports

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“…More recently, many investigators have identified its value in critical care settings. Some found that BNP might be helpful in guiding fluid therapy [13], and others found that BNP was associated with clinical outcomes [14,15]. However, these results are conflicting due to the heterogeneity of study subjects.…”

Section: Introductionmentioning

confidence: 99%

Prognostic value of B-type natriuretic peptide (BNP) and its potential role in guiding fluid therapy in critically ill septic patients

Zhang

Xue

et al. 2012

Scand J Trauma Resusc Emerg Med

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Background and objectivesThe prognostic role of B-type natriuretic peptide (BNP) in septic patients is controversial. The study aimed to investigate the prognostic value of BNP in critically ill septic patients. Furthermore, because BNP is primarily released from ventricles in response to myocardial stretch, the second aim of the study was to test whether the change in BNP was correlated to the amount of fluid balance.MethodsThis was a prospective observational study conducted in a tertiary 18-bed ICU. Patients fulfilled criteria of sepsis were enrolled. Exclusion criteria included renal dysfunction on ICU entry, age < 18 or >80 years old. BNP was measured on entry (BNP0) and day 3 (BNP1) and daily fluid balance over the three days were recorded. Diagnostic performances of BNP0 and ΔBNP (BNP1-BNP0) were analyzed. The correlation between fluid balance and ΔBNP were tested using Spearman’s correlation test.ResultsA total of 67 subjects were eligible for the study during study period. BNP0 was significantly higher in non-survivors than in survivors (738 vs 550 pg/ml, p < 0.01). The area under curves (AUCs) of BNP0 in predicting mortality, duration of mechanical ventilation (MV) > 7 d, length of stay in ICU (LOSICU) > 7 d and hospital (LOShospital) > 12 d were 0.71, 0.79, 0.66 and 0.71, respectively. The AUCs of ΔBNP in predicting duration of MV > 7 d, LOSICU > 7 d and LOShospital > 12 d were 0.80, 0.84 and 0.85, respectively. The amount of fluid balance was correlated to ΔBNP (Spearman’s rho = 0.63, p < 0.01), and the correlation remained statistically significant in multivariate model.ConclusionsBNP measured on ICU entry is associated with mortality, duration of MV, LOSICU and LOShospital. ΔBNP is able to predict the LOSICU and LOShospital with satisfactory sensitivity and specificity. ΔBNP is closely correlated to the amount of fluid balance during resuscitation period. However, this could only be considered as a hypothesis-generating pilot study due to its small sample size and the observational nature.

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“…Recently, BNP has also been used in critical care units for purposes such as guiding fluid therapy, predicting clinical outcomes of critical illness (Yamanouchi et al 2010;Wang et al 2012;Li et al 2013). In our previous studies, we found that rhBNP had protective effects on lipopolysaccharide (LPS)induced organ injuries (Song et al 2013;Li et al 2014;Yang et al 2014).…”

mentioning

confidence: 98%

“…Recently, BNP has also been used in critical care units for purposes such as guiding fluid therapy, predicting clinical outcomes of critical illness (Yamanouchi et al . ; Wang et al . ; Li et al .…”

mentioning

confidence: 99%

Recombinant human brain natriuretic peptide attenuates trauma‐/haemorrhagic shock‐induced acute lung injury through inhibiting oxidative stress and the NF‐κB‐dependent inflammatory/MMP‐9 pathway

Song

Zhao

Liu

et al. 2015

Int J Experimental Path

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Acute lung injury (ALI) is one of the most serious complications in traumatic patients and is an important part of multiple organ dysfunction syndrome (MODS). Recombinant human brain natriuretic peptide (rhBNP) is a peptide with a wide range of biological activity. In this study, we investigated local changes in oxidative stress and the NF-κB-dependent matrix metalloproteinase-9 (MMP-9) pathway in rats with trauma/haemorrhagic shock (TH/S)-induced ALI and evaluated the effects of pretreatment with rhBNP. Forty-eight rats were randomly divided into four groups: sham operation group, model group, low-dosage rhBNP group and high-dosage rhBNP group (n = 12 for each group). Oxidative stress and MPO activity were measured by ELISA kits. MMP-9 activity was detected by zymography analysis. NF-κB activity was determined using Western blot assay. With rhBNP pretreatment, TH/S-induced protein leakage, increased MPO activity, lipid peroxidation and metalloproteinase (MMP)-9 activity were inhibited. Activation of antioxidative enzymes was reversed. The phosphorylation of NF-κB and the degradation of its inhibitor IκB were suppressed. The results suggested that the protection mechanism of rhBNP is possibly mediated through upregulation of anti-oxidative enzymes and inhibition of NF-κB activation. More studies are needed to further evaluate whether rhBNP is a suitable candidate as an effective inhaling drug to reduce the incidence of TH/S-induced ALI.

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Blood N-Terminal proBNP as a Potential Indicator of Cardiac Preload in Patients with High Volume Load

Abstract: Keywords: brain natriuretic peptide; NT-proBNP; cardiac index; global end-diastolic volume index Tohoku

Cited by 21 publications

References 23 publications

Recombinant human brain natriuretic peptide attenuates LPS-induced cellular injury in human fetal lung fibroblasts via inhibiting MAPK and NF-κB pathway activation

Recombinant human brain natriuretic peptide attenuates LPS-induced cellular injury in human fetal lung fibroblasts via inhibiting MAPK and NF-κB pathway activation

Prognostic value of B-type natriuretic peptide (BNP) and its potential role in guiding fluid therapy in critically ill septic patients

Recombinant human brain natriuretic peptide attenuates trauma‐/haemorrhagic shock‐induced acute lung injury through inhibiting oxidative stress and the NF‐κB‐dependent inflammatory/MMP‐9 pathway

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