Endogenous Digoxin-Like Immunoreactivity in Urine of Preterm Infants with Late Hyponatremia

Kovács, László; Lichardus, B; Bircák, J; Ponecová, M; A, Masurová; Stefániková, J; Bruchác, D; Sulyok, E.

doi:10.1159/000415391

Cited by 3 publications

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“…Moreover, sodium supplementation has been found to be associated with increased plasma level and urinary excretion of salt-losing substances and significant positive correlation has been observed between these substances and renal sodium excretion [8,21].…”

Section: Introductionmentioning

confidence: 99%

Postnatal course of plasma levels of adrenocortical steroids in premature infants with and without NaCl supplementation

Sulyok¹,

Dörr

Ertl

et al. 1988

Eur J Pediatr

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To assess the adrenocortical response of premature infants to alterations in sodium balance, the postnatal course of plasma progesterone, 11-deoxycorticosterone, corticosteronoe, aldosterone, 17-hydroxyprogesterone, 11-deoxycortisol, cortisol and cortisone was compared in healthy premature infants kept on low (1-2 mEq/kg per day) or high (3-5 mEq/kg per day) sodium diet. The mean birthweight (1470 g, range: 1210-1670 g vs 1410 g, range: 1130-1750 g) and mean gestational age (30.5 weeks, range: 29-32 weeks vs 30.2 weeks, range: 28-32 weeks) in the low and high sodium groups, respectively, were similar. Simultaneous steroid hormone measurements were made weekly up to the 5th week of life using mechanized Sephadex LH-20 multicolumn chromatography and standardized radioimmunoassays. It was demonstrated that in response to renal salt wasting and negative sodium balance there was a significant rise in plasma aldosterone concentration. The plasma levels of other individual corticosteroids generally declined with advancing age, the initial fall, however, was followed by a transient and insignificant but simultaneous increase in 11-deoxycortisol, cortisol, cortisone and corticosterone in prematures on low a sodium diet. This effect could be prevented by giving NaCl supplement. The NaCl-suppressible increase in adrenocortical activity may be the result of the combined effect of stress or angiotensin 11-induced adrenocorticotropic hormone (ACTH) release and/or prolactin-mediated enhanced adrenal response to ACTH.

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Section: Introductionmentioning

confidence: 99%

Postnatal course of plasma levels of adrenocortical steroids in premature infants with and without NaCl supplementation

Sulyok¹,

Dörr

Ertl

et al. 1988

Eur J Pediatr

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Endogenous Regulation of Sodium Pump Activity

Doris¹

1994

Ion Channels and Ion Pumps

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Role of endogenous digitalis-like factors in the clinical manifestations of severe preeclampsia: a systematic review

Buckalew

2018

Clinical Science

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Endogenous digitalis-like factor(s), originally proposed as a vasoconstrictor natriuretic hormone, was discovered in fetal and neonatal blood accidentally because it cross-reacts with antidigoxin antibodies (ADAs). Early studies using immunoassays with ADA identified the digoxin-like immuno-reactive factor(s) (EDLF) in maternal blood as well, and suggested it originated in the feto-placental unit. Mammalian digoxin-like factors have recently been identified as at least two classes of steroid compounds, plant derived ouabain (O), and several toad derived bufodienolides, most prominent being marinobufagenin (MBG). A synthetic pathway for MBG has been identified in mammalian placental tissue. Elevated maternal and fetal EDLF, O and MBG have been demonstrated in preeclampsia (PE), and inhibition of red cell membrane sodium, potassium ATPase (Na, K ATPase (NKA)) by EDLF is reversed by ADA fragments (ADA-FAB). Accordingly, maternal administration of a commercial ADA-antibody fragment (FAB) was tested in several anecdotal cases of PE, and two, small randomized, prospective, double-blind clinical trials. In the first randomized trial, ADA-FAB was administered post-partum, in the second antepartum. In the post-partum trial, ADA-FAB reduced use of antihypertensive drugs. In the second trial, there was no effect of ADA-FAB on blood pressure, but the fall in maternal creatinine clearance (CrCl) was prevented. In a secondary analysis using the pre-treatment maternal level of circulating Na, K ATPase (NKA) inhibitory activity (NKAI), ADA-FAB reduced the incidence of pulmonary edema and, unexpectedly, that of severe neonatal intraventricular hemorrhage (IVH). The fall in CrCl in patients given placebo was proportional to the circulating level of NKAI. The implications of these findings on the pathophysiology of the clinical manifestations PE are discussed, and a new model of the respective roles of placenta derived anti-angiogenic (AAG) factors (AAGFs) and EDLF is proposed.

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Endogenous Digoxin-Like Immunoreactivity in Urine of Preterm Infants with Late Hyponatremia

Cited by 3 publications

References 0 publications

Postnatal course of plasma levels of adrenocortical steroids in premature infants with and without NaCl supplementation

Postnatal course of plasma levels of adrenocortical steroids in premature infants with and without NaCl supplementation

Endogenous Regulation of Sodium Pump Activity

Role of endogenous digitalis-like factors in the clinical manifestations of severe preeclampsia: a systematic review

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