呼吸器疾患におけるアドレノメデュリンおよび関連ペプチドに関する臨床的検討
アドレノメデュリン(AM)およびAM前駆体に由来する関連ペプチドPAMPは, 降圧作用のほかに気管支拡張作用も有する生理活性ペプチドである. 呼吸器疾患におけるAMおよびPAMPの病態生理学的意義を調べる目的で, 慢性呼吸器疾患, 気管支喘息発作の患者にっいて血漿AM, PAMP濃度を検討した. 種々の慢性呼吸器疾患患者において, 血漿AM, PAMP濃度は, 健常者に比し高値を示した. 次にこれらを呼吸困難の重症度別に分けると, 重症度の高いHugh-Jones分類のIV, V度で血漿AM, PAMP濃度は有意な高値を示した. また, 肺気腫, 気管支喘息では, 血漿AM, PAMP濃度と動...
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| Published in | 医療 Vol. 52; no. 7; pp. 415 - 420 |
|---|---|
| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 国立医療学会
1998
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0021-1699 1884-8729 |
| DOI | 10.11261/iryo1946.52.415 |
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| Abstract | アドレノメデュリン(AM)およびAM前駆体に由来する関連ペプチドPAMPは, 降圧作用のほかに気管支拡張作用も有する生理活性ペプチドである. 呼吸器疾患におけるAMおよびPAMPの病態生理学的意義を調べる目的で, 慢性呼吸器疾患, 気管支喘息発作の患者にっいて血漿AM, PAMP濃度を検討した. 種々の慢性呼吸器疾患患者において, 血漿AM, PAMP濃度は, 健常者に比し高値を示した. 次にこれらを呼吸困難の重症度別に分けると, 重症度の高いHugh-Jones分類のIV, V度で血漿AM, PAMP濃度は有意な高値を示した. また, 肺気腫, 気管支喘息では, 血漿AM, PAMP濃度と動脈血酸素分圧との間に有意な負の相関関係が認められた. 気管支喘息患者の発作時と緩解時の比較では, 緩解時に血漿AM, PAMP濃度が有意に低下した. 以上よりAMおよびPAMPは, 肺血管拡張作用や気管支拡張作用などの多彩な生理活性を介して呼吸器疾患の病態に関与している可能性が示唆された. |
|---|---|
| AbstractList | アドレノメデュリン(AM)およびAM前駆体に由来する関連ペプチドPAMPは, 降圧作用のほかに気管支拡張作用も有する生理活性ペプチドである. 呼吸器疾患におけるAMおよびPAMPの病態生理学的意義を調べる目的で, 慢性呼吸器疾患, 気管支喘息発作の患者にっいて血漿AM, PAMP濃度を検討した. 種々の慢性呼吸器疾患患者において, 血漿AM, PAMP濃度は, 健常者に比し高値を示した. 次にこれらを呼吸困難の重症度別に分けると, 重症度の高いHugh-Jones分類のIV, V度で血漿AM, PAMP濃度は有意な高値を示した. また, 肺気腫, 気管支喘息では, 血漿AM, PAMP濃度と動脈血酸素分圧との間に有意な負の相関関係が認められた. 気管支喘息患者の発作時と緩解時の比較では, 緩解時に血漿AM, PAMP濃度が有意に低下した. 以上よりAMおよびPAMPは, 肺血管拡張作用や気管支拡張作用などの多彩な生理活性を介して呼吸器疾患の病態に関与している可能性が示唆された. |
| Author | 下窪, 徹 比嘉, 利信 北村, 和雄 田中, 雅之 隈本, 健司 江藤, 胤尚 石畠, 英昭 鬼塚, 黎子 |
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| References | 27) Nishikimi T, Kitamura K, Saito Y et al: Clinical studies on the sites of production and clearance of circulating adrenomedullin in human subjects, Hypertension 24: 600-604, 1994 20) Lippton H, Chang J-K, Hao Q et al: Adrenomedullin dilates the pulmonary vascular bed in vivo, J Appl Physiol 76: 2154-2156, 1994 21) 中川修, 中尾一和: ナトリウム利尿ペプチド, 現代医療 27: 1709-1714, 1995 14) Ishimitsu T, Nishikimi T, Saito Y et al: Plasma levels of adrenomedullin, a newly identified hypotensive peptide, in patients with hypertension and renal failure, J Clin Invest 94: 2158-2161, 1994 13) Washimine H, Kitamura K Ichiki Y et al: Immunoreactive proadrenomedullin N-terminal 20 peptide in human tissue, plasma and urine, Biochem Biophys Res Commun 202: 1081-1087, 1994 1) Kitamura K, Kangawa K, Kawamoto M et al: Adrenomedullin: a novel hypotensive peptide isolated from human pheochromocytoma, Biochem Biophys Res Commun 192: 553-560, 1993 11) Kitamura K, Kangawa K, Ishiyama Y et al: Identification and hypotensive activity of proadrenomedullin N-terminal 20 peptide (PAMP), FEBS Lett 351: 35-37, 1994 16) Washimine H, Yamamoto Y, Kitamura K et al: Plasma concentration of human adrenomedullin in patients on hemodialysis, Clin Nephrol 44: 389-393, 1995 19) Yoshibayashi M, Kamiya T, Kitamura K et al: Plasma levels of adrenomedullin in primary and secondary pulmonary hypertension in patients<20 years of age, Am J Cardiol 79: 1556-1558, 1997 22) Takeda T, Kohno M: Brain natriuretic peptide in hypertension, Hypertens Res 18: 259-266, 1995 24) Sugo S, Minamino N, Kangawa K et al: Endothelial cells actively synthesize and secrete adrenomedullin, Biochem Biophys Res Commun 201: 1160-1166, 1994 26) Owji AA, Smith DM, Coppock HA et al: An abundant and specific binding site for the novel vasodilator adrenomedullin in the rat, Endocrinology 136: 2127-2134, 1995 3) Ebara T, Miura K, Okumura M et al: Effect of adrenomedullin on renal hemodynamics and functions in dogs, Eur J Pharmacol 263: 69-73, 1994 6) Kanzawa H, Kurihara N, Hirata K et al: Adrenomedullin, a newly discovered hypotensive peptide, is a potent bronchodilator, Biochem Biophys Res Commun 205: 251-254, 1994 5) Kitamura K, Sakata J, Kangawa K et al: Cloning and characterization of cDNA encoding a precursor for human adrenomedullin, Biochem Biophys Res Commun 194: 720-725, 1993 17) Martlnez A, Miller MJ, Unsworth EJ et al: Expression of adrenomedullin in normal human lung and in pulmonary tumors, Endocrinology 136: 4099-4105, 1995 4) Shimosawa T, Ito Y, Ando K et al: Proadrenomedullin NH2-terminal 20 peptide, a new product of the adrenomedullin gene, inhibits norepinephrine overflow from nerve endings, J Clin Invest 96: 1672-1676, 1995 7) Kanazawa H, Kawaguchi T, Fujii T et al: Comparison of bronchodilator responses to adrenomedullin and proadrenomedullin N-terminal 20 peptide, Life Sci 57: PL 241-245, 1995 9) Kitamura K, Ichiki Y, Tanaka M et al: Immunoreactive adrenomedullin in human plasma, FEBS Lett 341: 288-290, 1994 23) Kato J, Kobayashi K, Etoh T et al: Plasma adrenomedullin concentration in patients with heart failure, J Clin Endocrinol Metab 81: 180-183, 1996 8) 下窪徹, 比嘉利信, 田中雅之ほか: 呼吸器疾患における血漿アドレノメデュリンおよびPAMP濃度に関する検討, 臨床と研究 74: 2507-2510, 1997 10) Kuwasako K, Kitamura K, Ichiki Y et al: Human proadrenomedullin N-terminal 20 peptide in pheochromocytoma and normal adrenal medulla, Biochem Biophys Res Commun 211: 694-699, 1995 12) Ichiki Y, Kitamura K, Kangawa K et al: Distribution and characterization of immunoreactive adrenomedullin in human tissue and plasma, FEBS Lett 338: 6-10, 1994 18) Shimokubo T, Sakata J, Kitamura K et al: Augmented adrenomedullin concentrations in right ventricle and plasma of experimental pulmonary hypertension, Life Sci 57: 1771-1779, 1995 2) Ishiyama Y, Kitamura K, Ichiki Y et al: Hemodynamic effects of a novel hypotensive peptide, human adrenomedullin, in rats, Eur J Pharmacol 241: 271-273, 1993 25) Sugo S, Minamino N, Shoji H et al: Interleukin-1, tumor necrosis factor and lipopolysaccharide additively stimulate production of adrenomedullin in vascular smooth muscle cells, Biochem Biophys Res Commun 207: 25-32, 1995 15) Kobayashi K, Kitamura K, Etoh T et al: Increased plasma adrenomedullin levels in patients with chronic congestive heart failure, Am Heart J 131: 994-998, 1996 |
| References_xml | – reference: 14) Ishimitsu T, Nishikimi T, Saito Y et al: Plasma levels of adrenomedullin, a newly identified hypotensive peptide, in patients with hypertension and renal failure, J Clin Invest 94: 2158-2161, 1994 – reference: 23) Kato J, Kobayashi K, Etoh T et al: Plasma adrenomedullin concentration in patients with heart failure, J Clin Endocrinol Metab 81: 180-183, 1996 – reference: 1) Kitamura K, Kangawa K, Kawamoto M et al: Adrenomedullin: a novel hypotensive peptide isolated from human pheochromocytoma, Biochem Biophys Res Commun 192: 553-560, 1993 – reference: 12) Ichiki Y, Kitamura K, Kangawa K et al: Distribution and characterization of immunoreactive adrenomedullin in human tissue and plasma, FEBS Lett 338: 6-10, 1994 – reference: 7) Kanazawa H, Kawaguchi T, Fujii T et al: Comparison of bronchodilator responses to adrenomedullin and proadrenomedullin N-terminal 20 peptide, Life Sci 57: PL 241-245, 1995 – reference: 24) Sugo S, Minamino N, Kangawa K et al: Endothelial cells actively synthesize and secrete adrenomedullin, Biochem Biophys Res Commun 201: 1160-1166, 1994 – reference: 13) Washimine H, Kitamura K Ichiki Y et al: Immunoreactive proadrenomedullin N-terminal 20 peptide in human tissue, plasma and urine, Biochem Biophys Res Commun 202: 1081-1087, 1994 – reference: 4) Shimosawa T, Ito Y, Ando K et al: Proadrenomedullin NH2-terminal 20 peptide, a new product of the adrenomedullin gene, inhibits norepinephrine overflow from nerve endings, J Clin Invest 96: 1672-1676, 1995 – reference: 11) Kitamura K, Kangawa K, Ishiyama Y et al: Identification and hypotensive activity of proadrenomedullin N-terminal 20 peptide (PAMP), FEBS Lett 351: 35-37, 1994 – reference: 5) Kitamura K, Sakata J, Kangawa K et al: Cloning and characterization of cDNA encoding a precursor for human adrenomedullin, Biochem Biophys Res Commun 194: 720-725, 1993 – reference: 21) 中川修, 中尾一和: ナトリウム利尿ペプチド, 現代医療 27: 1709-1714, 1995 – reference: 9) Kitamura K, Ichiki Y, Tanaka M et al: Immunoreactive adrenomedullin in human plasma, FEBS Lett 341: 288-290, 1994 – reference: 2) Ishiyama Y, Kitamura K, Ichiki Y et al: Hemodynamic effects of a novel hypotensive peptide, human adrenomedullin, in rats, Eur J Pharmacol 241: 271-273, 1993 – reference: 3) Ebara T, Miura K, Okumura M et al: Effect of adrenomedullin on renal hemodynamics and functions in dogs, Eur J Pharmacol 263: 69-73, 1994 – reference: 16) Washimine H, Yamamoto Y, Kitamura K et al: Plasma concentration of human adrenomedullin in patients on hemodialysis, Clin Nephrol 44: 389-393, 1995 – reference: 26) Owji AA, Smith DM, Coppock HA et al: An abundant and specific binding site for the novel vasodilator adrenomedullin in the rat, Endocrinology 136: 2127-2134, 1995 – reference: 19) Yoshibayashi M, Kamiya T, Kitamura K et al: Plasma levels of adrenomedullin in primary and secondary pulmonary hypertension in patients<20 years of age, Am J Cardiol 79: 1556-1558, 1997 – reference: 8) 下窪徹, 比嘉利信, 田中雅之ほか: 呼吸器疾患における血漿アドレノメデュリンおよびPAMP濃度に関する検討, 臨床と研究 74: 2507-2510, 1997 – reference: 6) Kanzawa H, Kurihara N, Hirata K et al: Adrenomedullin, a newly discovered hypotensive peptide, is a potent bronchodilator, Biochem Biophys Res Commun 205: 251-254, 1994 – reference: 17) Martlnez A, Miller MJ, Unsworth EJ et al: Expression of adrenomedullin in normal human lung and in pulmonary tumors, Endocrinology 136: 4099-4105, 1995 – reference: 10) Kuwasako K, Kitamura K, Ichiki Y et al: Human proadrenomedullin N-terminal 20 peptide in pheochromocytoma and normal adrenal medulla, Biochem Biophys Res Commun 211: 694-699, 1995 – reference: 25) Sugo S, Minamino N, Shoji H et al: Interleukin-1, tumor necrosis factor and lipopolysaccharide additively stimulate production of adrenomedullin in vascular smooth muscle cells, Biochem Biophys Res Commun 207: 25-32, 1995 – reference: 15) Kobayashi K, Kitamura K, Etoh T et al: Increased plasma adrenomedullin levels in patients with chronic congestive heart failure, Am Heart J 131: 994-998, 1996 – reference: 27) Nishikimi T, Kitamura K, Saito Y et al: Clinical studies on the sites of production and clearance of circulating adrenomedullin in human subjects, Hypertension 24: 600-604, 1994 – reference: 18) Shimokubo T, Sakata J, Kitamura K et al: Augmented adrenomedullin concentrations in right ventricle and plasma of experimental pulmonary hypertension, Life Sci 57: 1771-1779, 1995 – reference: 20) Lippton H, Chang J-K, Hao Q et al: Adrenomedullin dilates the pulmonary vascular bed in vivo, J Appl Physiol 76: 2154-2156, 1994 – reference: 22) Takeda T, Kohno M: Brain natriuretic peptide in hypertension, Hypertens Res 18: 259-266, 1995 |
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| Snippet | アドレノメデュリン(AM)およびAM前駆体に由来する関連ペプチドPAMPは, 降圧作用のほかに気管支拡張作用も有する生理活性ペプチドである. 呼吸器疾患におけるAMおよびPAMPの病態生理学的意義を調べる目的で, 慢性呼吸器疾患, 気管支喘息発作の患者にっいて血漿AM, PAMP濃度を検討した.... |
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| SubjectTerms | PAMP アドレノメデュリン 呼吸器疾患 慢性呼吸不全 気管支喘息 |
| Title | 呼吸器疾患におけるアドレノメデュリンおよび関連ペプチドに関する臨床的検討 |
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