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  • 1
  • 2
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  42. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh); 28. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh); 24. wissenschaftliche Jahrestagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR); 20140917-20140920; Düsseldorf; DOCRA.02 /20140912/
    Publication Date: 2014-09-13
    Keywords: rheumatoide Arthritis ; seronegativ ; Autoantikörper ; ddc: 610
    Language: German
    Type: conferenceObject
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  • 3
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  45. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh), 31. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh), 27. Jahrestagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR); 20170906-20170909; Stuttgart; DOCVK.05 /20170904/
    Publication Date: 2017-09-04
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 4
    ISSN: 1432-055X
    Keywords: Schlüsselwörter CDD/ANP-99 ; 126 ; Urodilatin (URO) ; akutes Nierenversagen ; Herztransplantation (HTx) ; Lebertransplantation (LTx) ; Hämodialyse ; Hämofiltration ; Key words CDD/ANP-99 ; 126 ; Urodilatin (URO) ; Acute renal failure (ARF) ; Heart transplantation (HTx) ; Liver transplantation (LTx) ; Hemodialysis ; Hemofiltration
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract On the subject of natriuretic peptides there is a great deal of controversy, and intensive research efforts have been made studying their effects on electrolyte homeostasis. In the early 1980s, a peptide that caused diuresis, natriuresis, and had a relaxant effect on vascular smooth muscle was discovered independently by several groups. This was the breakthrough for the identification of natriuretic peptides, followed by the characterisation of the amino-acid sequences of several species. Synthesis of the peptide, cloning of the encoding gene, identification and characterisation of specific receptors, as well as the development of antibodies and radioimmunoassays were rapidly accomplished. Research on the immunohistochemistry of cardiodilatin/atrial natriuretic peptide (CDD/ANP) and the regulation of CDD/ANP gene expression led to detection of the peptide in extra-atrial tissues. Later on, two new peptides were discovered brain natriuretic peptide (BNP) and C-type natriuretic peptide (CNP). These peptides share structural features with CDD/ANP with regard to their 17-amino-acid-exhibiting loop bridged by a disulfide bond. Another recently discovered peptide is urodilatin (URO), a renal-borne new member of A-type natriuretic peptide. URO was isolated from human urine and consists of the same sequence as CDD/ANP, containing the 17-amino-acid residue loop of the circulating hormone with 4 additional amino acids located at the NH2-terminus of the peptide. Regarding physiological actions, data strongly support a close association between URO and urinary sodium excretion. The application of URO in animals revealed a stronger diuresis and natriuresis with a lower influence on arterial blood pressure compared to CDD/ANP-99–126. These results were encouraging for the use of URO in clinical trials as a tool to prevent acute renal failure (ARF) in patients following heart transplantation and for treatment of incipient ARF in patients following liver transplantation. Summarising the results of these two studies, URO represents a new approach for not only prevention, but also for treatment of ARF following organ transplantation. This opens up new possibilities for the treatment of ARF of other origins in intensive care medicine.
    Notes: Zusammenfassung Nach der Isolierung der ersten kardialen Hormone mit diuretischer und natriuretischer Wirkung, die als Cardiodilatin oder atrial natriuretisches Peptid (CDD/ANP) bezeichnet werden, führten weitere Untersuchungen zur Entdeckung des Brain Natriuretic Peptide (BNP) [126] und des natriuretischen Peptids vom C-Typ (CNP) [127]. Weiter wurde 1988 Urodilatin (URO) isoliert, ein natriuretisches Peptid aus dem menschlichen Urin. In tierexperimentellen und klinischen Untersuchungen konnte die physiologische Bedeutung für die Regulation der Salz- und Wasserausscheidung durch die enge Korrelation zwischen URO und Natriumausscheidung im Urin gezeigt werden. Nach ersten Ergebnissen in Tierversuchsreihen u.a. an kardiomyopathischen Hunden wurde die Wirkung von URO bei Patienten mit kardiovaskulären Erkrankungen oder bei hämodynamischer Instabilität erstmals untersucht. In zwei abgeschlossenen Studien bei leber- und herztransplantierten Patienten konnte in der Mehrzahl ein protrahiertes akutes Nierenversagen verhindert werden. So steht mit Urodilatin ein Medikament zur Verfügung, das neben der Prophylaxe und Therapie des akuten Nierenversagens nach Herz- oder Lebertransplantation auch für die Behandlung des akuten Nierenversagens anderer Ätiologie neue Perspektiven eröffnet.
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  • 5
    ISSN: 1432-055X
    Keywords: Schlüsselwörter Urodilatin ; Ularitide ; Akutes Nierenversagen (ANV) ; Lebertransplantation (LTx) ; Hämodialyse ; Hämofiltration ; Key words Urodilatin ; Ularitide ; Acute renal failure (ARF) ; Liver transplantation (LTx) ; Hemodialysis ; Hemofiltration
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Acute renal failure (ARF) is a serious complication following liver transplantation. Many therapeutic regimens have been used so far but with limited success. Urodilatin (URO) is a new member of the atrial natriuretic peptide (ANP) family. When administered intravenously, URO induces strong diuresis and natriuresis with tolerable hemodynamic side effects. Preliminary non-controlled clinical studies demonstrate beneficial effects using URO as a therapeutic agent in patients suffering from ARF following heart and liver transplantation (HTx, LTx). These results prompted us to initiate this first controlled clinical trial to investigate whether URO infusion can improve renal function in patients with emerging ARF following LTx. Method. We initiated a randomized, double-blind, placebo-controlled study comparing five patients receiving i.v. URO infusion (20 ng/kg bw/min) with four placebo patients after informed consent was obtained. Optional inclusion criteria were oliguria/anuria (〈0.5 ml/kg/h), refractory to conventional treatment including administration of furosemide and dopamine, increase of serum creatinine to a least 200% of preoperative values, and BUN levels ≥25 mmol/l. The primary parameters for efficacy was the frequency of hemodialysis/hemofiltration. Results. The frequency of hemodialysis/hemofiltration during URO or placebo infusion was significantly reduced (P=0.03) in the URO-treated patients in comparison with placebo. BUN levels did not differ between two groups, but serum creatinine levels were consistently lower in the URO group. Diuresis tended to be stronger in the URO group, maintaining high levels despite a significant reduction in the administration of furosemide in comparison with placebo. Conclusion. We conclude that URO seems to be a new approach for the treatment of therapy-resistant postoperative ARF following LTx.
    Notes: Zusammenfassung Trotz vieler unterschiedlicher neuer Therapieversuche, stellt das postoperative ANV auch heute noch ein nicht gelöstes Problem dar. 1988 wurde Urodilatin (URO), ein natriuretisches Peptid, aus dem menschlichen Urin isoliert. Nachdem 2 nicht kontrollierte, klinische Studien mit URO zur Prophylaxe und Therapie des ANV nach Herz- bzw. Lebertransplantation (HTx, LTx) mit Erfolg durchgeführt wurden, initiierten wir diese erste doppelblinde, Plazebo-kontrollierte Studie zur Therapie des ANV nach LTx. Wir verglichen 5 URO (20 ng/kg KG/min) mit 4 Plazebopatienten. Eines der folgenden Einschlußkriterien mußte innerhalb von 7 Tagen nach LTx erfüllt sein: Diuretika-resistente Oligurie/Anurie (〈0,5 ml/kg/h), Verdopplung des Serum-Kreatininwerts bezogen auf den Wert vor Beginn der LTx und ein Anstieg des Serum-Harnstoffs ≥25 mmol/l. Die Ergebnisse zeigen, daß URO signifikant die Hämodialyse-/Hämofiltrationshäufigkeit im Vergleich zu den mit Plazebo behandelten Patienten (p=0,03) senkt und eine Diurese induziert, die bei gleichzeitiger Reduktion der Furosemidapplikation stärker ist als in der Plazebogruppe. Wir schließen aus diesen ersten Ergebnissen einer kontrollierten Doppelblindstudie, daß URO ein potentes Medikament für die Therapie des postoperativen ANV nach LTx sein könnte.
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  • 6
    ISSN: 0014-5793
    Keywords: Cyclic GMP ; Guanylate cyclase ; Guanylin ; Hemofiltrate ; Peptide hormone
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Biology , Chemistry and Pharmacology , Physics
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  • 7
    ISSN: 1433-8726
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary An increase in cyclic nucleotide monophosphate levels is suggested to play a prominent role in mediating smooth-muscle relaxation. Cyclic nucleotide phosphodiesterase (PDE) influences smooth-muscle tone by decreasing the level of cyclic nucleotides. At present, five different families of isoenzymes of PDE exist that show a distinct species- and organ-specific distribution. Our study was done to evaluate the existence of specific PDE isoenzymes and its functional role in human ureteral tissue. Normal ureteral tissue was homogenized and centrifuged and the supernatant fraction was separated using anioin-exchange diethylaminoethyl (DEAE)-Sephacel chromatography. A PDE assay was then performed and the peak fractions were added to different specific PDE activators and inhibitors. In vitro, longitudinal ureteral strips were precontracted and different selective and nonselective PDE inhibitors were added incremently. Three different PDE isoenzymes were characterized: PDE I (calmodulin-sensitive), PDE II (cGMP-stimulated), and PDE IV (cAMP-specific). All PDE inhibitors relaxed the strips dose-dependently, with the 50% effective concentrations (EC50) being 30 μM for papaverine, 40 μM for zaprinast, 25 μM for quazinone, and 0.1 μM for rolipram. The ureter-relaxing effect of the PDE IV inhibitor at low concentrations, combined with its low-level effect on the systemic circulatory parameters, may open the possibility of using selective PDE IV- inhibitors in the treatment of ureteral colics or for ureteral stone passage.
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  • 8
    ISSN: 1432-1440
    Keywords: Cardiodilation (CDD) ; Urodilatin ; Posttranslational Processing ; Cardiac Hormones ; Atrial Natriuretic Polypeptide (ANP) ; Urine ; Polypeptide Hormone ; Amino Acid Sequence
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Two major forms of cardiac peptides have been established in the last few years: (a) a prohormone of 126 amino acids (CDD/ANP-1-126) in the endocrine heart and (b) the circulating CDD/ANP-99-126 (=alpha ANP) in blood plasma. The method we applied earlier to isolate the circulating form of cardiodilatin from human blood was used to detect and analyze the biologically active, predominant form of the same polypeptide family excreted by the kidneys. Each step of the isolation procedure was followed up by a bioassay using an in vitro vascular smooth muscle relaxation test and a highly specific RIA against cardiodilatin (CDD-99-126) for the initial purification steps. The polypeptides excreted in 1000 1 of normal human urine were adsorbed to 2.5 kg of alginic acid, and after elution and lyophilization processed on a G-25 Sephadex column. The obtained crude polypeptide fractions were applied to ion-exchange chromatography. Thereafter four steps of HPLC were carried out to purify the polypeptide which was the suggested form of cardiodilatin (CDD) in human urine. The amino acid analysis and gas phase sequence analysis showed that the main form of urinary cardiodilatin is a 32 amino acid residue containing molecule, cardiodilatin-95–126. The molecule is N-terminally extended compared to the circulating CDD-99-126. This suggests that the analyzed urinary peptide is not the residual plasma form, filtrated and renally cleared from blood, but probably a polypeptide produced and processed in the kidney tubules and cleaved by a different postranslational process. Therefore, this vasorelaxant polypeptide is called urodilatin.
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  • 9
    ISSN: 1432-1440
    Keywords: Cardiodilatin (CDD) ; Posttranslational processing ; Cardiac hormones ; Atrial natriuretic polypeptide (ANP) ; Hemofiltrate ; Polypeptide hormone
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A new method was applied to isolate a polypeptide hormone from human blood. The polypeptides from 1,000 1 of hemofiltrate with a molecular weight lower than 20 kDaltons were adsorbed to 2.5 kg alginic acid, then eluted, precipitated, and desalted on a G-25 Sephadex column, thus obtaining a crude lyophilised plasma polypeptide extract. These polypeptides were further submitted to ion-exchange chromatography. Thereafter, two steps of HPLC were carried out to purify a distinct polypeptide which was the circulating form of cardiodilatin (CDD) in this case. The amino acid analysis, C-terminal enzymatic cleavage by carboxypeptidase A, and sequence analysis showed that the only form of circulating cardiodilatin is the 28 amino acid residue containing molecule, cardiodilatin-99-126 cleaved from the C-terminus of cardiodilatin-126 and identical with alpha-ANP (alpha atrial natriuretic polypeptide). Other bioactive molecular forms of the polypeptide hormones of the cardiodilatin family were not detected in the hemofiltrate. The isolation procedure was followed up by a bioassay using in vitro vascular smooth muscle relaxation.
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