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Biomedical subjects

C J Winters

Publications and source records attributed to C J Winters.

46 records · Page 3Linked to original sources

Prohormone atrial natriuretic peptides 1-30 and 31-67 increase in hyperthyroidism and decrease in hypothyroidism.

Hyperthyroidism characteristically has natriuresis and vasodilation associated with it, whereas hypothyroidism is associated with impaired water excretion and vasoconstriction. This investigation was designed to determine if the plasma concentration(s) of three newly described hormones synthesized in the heart are increased in patients with hyperthyroidism and/or decreased in patients with hypothyroidism compared to normal subjects. The three hormones consist of amino acids 1-30, 31-67, and 99-126 (ANF) of the 126 amino acid prohormone of atrial natriuretic factor. Prohormone atrial natriuretic peptides (pro ANFs) 1-30, 31-67, and ANF were increased threefold, fourfold, and twofold respectively in hyperthyroid patients compared to the mean circulating concentration of 54 healthy persons without thyroid disease. Plasma concentrations of the three peptides in hypothyroid patients were only one-half that of the 54 persons without thyroid disease. With appropriate treatment of hyperthyroidism and hypothyroidism, the levels of the three peptides returned to normal. The peptide hormones increased proportionately with the increasing dosages of L-thyroxine of 50 micrograms/day and 100 micrograms/day in the hypothyroid patients. In persons with hypothyroidism complicated by congestive heart failure, the levels of pro ANFs 1-30, 31-67, and 99-126 were increased, demonstrating that abnormalities of salt and water metabolism are a strong stimulus to the release of these peptides.

Adult↗

Prohormone atrial natriuretic peptides 1-98 and 31-67 increase with exercise in congestive heart failure patients.

Recently two peptides consisting of amino acids (a.a.) 1-30 and 31-67 of the N-terminus of the 126 a.a. prohormone of atrial natriuretic factor (pro ANF), as well as atrial natriuretic factor (ANF, a.a. 99-126; C-terminus) were found to have vasodilatory and natriuretic properties. These peptides, as well as ANF, circulate in man as part of the N-terminus of the prohormone. To determine the effect of graded exercise on the circulating concentration of the N-terminus and C-terminus of the ANF prohormone in persons with abnormal salt and water metabolism, 12 individuals with stable congestive heart failure (CHF) were evaluated before and after bicycle exercise testing and the results were subdivided based on the maximal exercise they could achieve. In all of the CHF patients, the circulating concentration of the whole N-terminus (ie, a.a. 1-98), the midportion of the N-terminus (pro ANF 31-67), which circulates as a distinct 3900 molecular weight (m.w.) peptide after being proteolytically cleaved from the N-terminus, and the C-terminus (ANF) increased with exercise. The patients who were able to achieve 100 and 125 watts of workload had a greater maximal oxygen consumption and, in general, a greater percent increase in the circulating concentration of both the N-terminus and the C-terminus of the ANF prohormone than those who had less exercise capacity. Evaluation of the echocardiographic, radionucleotide, and the exercise parameters revealed that the circulating concentrations of these atrial peptides correlated best with left atrial dimension, but that left ventricular systolic and diastolic dimensions also correlated positively with their concentrations.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

The N-terminus and a 4,000-MW peptide from the midportion of the N-terminus of the atrial natriuretic factor prohormone each circulate in humans and increase in congestive heart failure.

Two peptides consisting of amino acids 1-30 and 31-67 of the N-terminus of the prohormone of atrial natriuretic factor (pro-ANF) that have vasodilatory and natriuretic properties were investigated to determine if they circulate in humans. Specific and sensitive radioimmunoassays were developed to amino acids 1-30, 31-67, and 99-126 of pro-ANF. Evaluation of human plasma that had been subjected to reverse-phase high-pressure liquid chromatography suggested that pro-ANFs 1-30 and 31-67 as well as ANF were distinct peaks in human plasma corresponding exactly to pure synthetic peaks of these peptides on high-pressure liquid chromatography. Molecular weight determination of the endogenous immunoreactive peptides measured in plasma by G-50 Sephadex gel permeation chromatography revealed that the pro-ANF 1-30 radioimmunoassay recognized a peptide of 10,000 MW, which is consistent with it measuring the whole N-terminus of pro-ANF (amino acids 1-98) but without ANF (C-terminus) attached to it. The pro-ANF 31-67 radioimmunoassay recognized mainly (more than 95%) a peptide of 3,900-4,000 MW, which corresponds closely with its actual molecular weight of 3,878. Our ANF radioimmunoassay recognizes a peptide in plasma of 3,000 MW with the known molecular weight of ANF being 3,081. The mean circulating concentrations of immunoreactive pro-ANF 1-98, pro-ANF 31-67, and ANF in 54 control subjects were 531 +/- 25, 371 +/- 18, and 22 +/- 1 fmol/ml (+/- SEM), respectively. Thirty patients with varying severity of congestive heart failure were also studied. The N-terminus, C-terminus, and pro-ANF 31-67 increased: twofold for New York Heart Association functional Class II, threefold to ninefold for Class III, and 10- to 20-fold for Class IV patients with congestive heart failure. Thus, the N-terminus and a 4,000-MW peptide from the midportion of the N-terminus of pro-ANF as well as ANF circulate normally and increased proportionately to the increasing severity of congestive heart failure. However, because the pro-ANF 31-67 radioimmunoassay was the only assay that discriminated between patients with Class I congestive heart failure and control subjects, this assay may be the most useful to accurately classify the severity of congestive heart failure.

Adult↗

Atrial natriuretic factor in the pleural fluid of congestive heart failure patients.

To investigate the possibility that atrial natriuretic factor might be secreted into the pleural fluid of patients with congestive heart failure who are known to have high concentrations of this new peptide hormone circulating in their plasma, six patients with class 2 New York Heart Association classified congestive heart failure had simultaneos measurement of plasma and pleural fluid atrial natriuretic factor concentrations. Atrial natriuretic factor was found in high concentrations in the pleural fluid of all of these patients. The concentration of atrial natriuretic factor in pleural fluid was nearly equal to the concentration in plasma of these patients. Their plasma levels were double the plasma concentration of this peptide hormone in 54 persons without congestive heart failure. These preliminary findings demonstrate that atrial natriuretic factor is present in pleural fluid of patients with congestive heart failure, but whether or not this secretion of atrial natriuretic factor into the pleural fluid helps the lung clear the fluid present in the lung in congestive heart failure cannot be determined from the present investigation.

Atrial Natriuretic Factor↗

Increased circulating concentration of atrial natriuretic factor in persons with pheochromocytomas.

To investigate the possible relationship of atrial natriuretic factor (ANF) to hypertension, we examined the circulating levels of ANF in 3 patients with pheochromocytomas before surgery, during increase of their blood pressure with surgical manipulation of their tumors, and after surgery when their blood pressures returned to normal. The circulating levels of ANF were increased 2-fold in patients with both extra-adrenal and intra-adrenal pheochromocytomas. In both the intra-adrenal and extra-adrenal patients their ANF levels increased further during surgical manipulation and returned to normal after surgical removal of their respective tumors. Each of these pheochromocytomas was examined and found to have atrial natriuretic receptors that were functional since ANF could enhance the guanylate cyclase - cyclic GMP system two-fold in these pheochromocytomas. We conclude that ANF circulates at higher concentrations in persons with pheochromocytomas and returns to normal with removal of the tumor. In addition, pheochromocytomas contain specific ANF receptors and ANF itself within these tumors.

Adolescent↗

Increased release of the N-terminal and C-terminal portions of the prohormone of atrial natriuretic factor during immersion-induced central hypervolemia in normal humans.

The role of peptides from the N terminus and C terminus of the 126 amino acid atrial natriuretic factor (ANF) prohormone in modulating renal sodium and water handling has not been defined. Since water immersion to the neck (NI) provides an acute central volume expansion identical to that produced by 2 liters of saline but without plasma compositional change, immersion to the neck was used to assess the N-terminal and C-terminal portions of the ANF prohormone response to acute central blood volume expansion in seven seated sodium-replete normal subjects. Both the C terminus, which contains amino acids 99-126 and is identical to ANF, and the whole N terminus (i.e., amino acids 1-98) increased promptly with NI and peaked after 1 hr of immersion. A Mr 3900 peptide from the midportion of the N terminus consistent with amino acids 31-67 (i.e., pro-ANF-31-67) also increased with NI and followed a pattern of increasing circulating concentration nearly identical to that of the whole N terminus of the prohormone, except that its maximal concentration was at the second hour of the 3 hr of NI. With cessation of immersion, ANF decreased to preimmersion levels within 1 hr whereas the N terminus and pro-ANF-31-67, although their circulating concentrations were decreasing, were still significantly elevated at 1 hr. These findings suggest that the increase in plasma ANF, the N terminus of the ANF prohormone, and pro-ANF-31-67 from the midportion of the N terminus, with natriuretic properties similar to ANF, contribute to the natriuretic response to NI, implying a physiologic role for these atrial peptides in modulating volume homeostasis in humans.

Adult↗

Atrial natriuretic factor in the ascitic fluid of cirrhotic patients.

The simultaneous measurement of plasma and ascitic fluid atrial natriuretic factor (ANF) concentrations in six cirrhotic patients revealed that ANF is present in high concentrations (mean = 89 +/- 4 pg/ml) in the ascitic fluid of these patients. The concentration of atrial natriuretic factor in ascitic fluid was nearly equal to the concentration in plasma (96 +/- 8 pg/ml). The plasma levels of ANF in the cirrhotic patients were considerably higher than the mean plasma concentration of this peptide hormone in 54 persons without cirrhosis (67 +/- 3 pg/ml). The data demonstrate that atrial natriuretic factor is present in ascitic fluid in high concentrations that are nearly equal to that in plasma. This suggests that its presence in ascitic fluid is due to capillary leakage in the hepatic sinusoids.

Ascitic Fluid↗

Release of atrial natriuretic factor with increasing absolute atmospheres of pressure in a hyperbaric chamber and reversal with oxygen therapy.

Diving is associated with a marked diuresis which can be accurately reproduced in a hyperbaric chamber where the pressure of a specific depth can be precisely controlled. The present investigation was designed to determine if the diuresis observed with diving is associated with increased release of a new diuresis-producing hormone, atrial natriuretic factor (ANF). Seven experienced divers (3 men and 4 women; average age of 31 years) had their circulating concentration of atrial natriuretic factor measured at 1, 2 and 3 atmospheres of absolute pressure (ATA) in a monoplace hyperbaric chamber while breathing air. With the simulated dive to 33 feet (2 ATA), the circulating concentration of ANF increased 3-fold and at a depth of 66 feet (3 ATA) ANF increased 6-fold over the concentration at 1 ATA. With the addition of 100% oxygen while at depths of 33 and 66 feet, the concentration of ANF immediately decreased to its pre-dive concentration and remained there with further decompression to surface air and removal of oxygen supplementation. Thus, the increased release of ANF with depth may help to explain the diuresis observed with diving.

Adult↗

Two new hormones: prohormone atrial natriuretic peptides 1-30 and 31-67 circulate in man.

Two peptides consisting of amino acids 1-30 and 31-67 of the N-terminal end of the prohormone of atrial natriuretic factor (pro ANF) which vasodilate aortas in vitro, lower blood pressure in vivo, and have natriuretic properties were found to circulate in 54 normal human volunteers. The mean circulating concentration of pro ANF 1-30 was 1861 +/- 87 pg/ml (SEM) while pro ANF 31-67 mean concentration was 1478 +/- 71 pg/ml versus a level of 67 +/- 3 pg/ml for atrial natriuretic factor (ANF). In chronic renal failure their mean concentrations increased to 40,484 +/- 6,929 pg/ml (SEM), 108,566 +/- 16,888 pg/ml, and 348 +/- 81 pg/ml for pro ANFs 1-30 and 31-67 and ANF respectively. Since pro ANF 1-30 and pro ANF 31-67 circulate in man and have physiologic effects they meet the criteria of two new hormones.

Adult↗

Circadian rhythm of prohormone atrial natriuretic peptides 1-30, 31-67 and 99-126 in man.

Two peptides consisting of amino acids 1-30 and 31-67 of the N-terminal end of the prohormone of the atrial natriuretic factor (pro ANF), vasodilate aortas in vitro, lower blood pressure in vivo, and have natriuretic properties similar to the atrial natriuretic factor (ANF, amino acids 99-126 of the prohormone). It has been recently discovered that pro ANF 1-30 and pro ANF 31-67 as well as ANF circulate in man. To determine if these three peptide hormones have a circadian variation in their circulating plasma concentrations, eight housestaff volunteers were studied on a day when they were in the hospital for 24 hr. These 5 men and 3 women, ages 25 to 39 had blood samples taken at 0800, 1200, 1600, 2000, 0000, 0400 and 0800 on the following day. One-half of these house officers were up all night while the other half went to sleep from midnight to 0800 and had their 0400 plasma samples drawn while in a supine position. The peak level for all three peptide hormones was at 0400 for both supine and upright subjects. It was concluded that there are circadian rhythms in normal, active people of these three peptide hormones, whose peak levels are at 0400 irrespective of posture.

Adult↗