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Biomedical subjects

J Menard

Publications and source records attributed to J Menard.

At least 127 records · Page 7Linked to original sources

Renin storage and cell differentiation in juxtaglomerular cell tumors: an immunohistochemical and ultrastructural study of three cases.

Three renin-secreting juxtaglomerular cell tumors were studied by ultrastructural and immunocytochemical methods. Both active and inactive renins were identified in tumor extracts. By immunofluorescence and the peroxidase-antiperoxidase (PAP) method with antirenin antiserum, immunolabeling was intracytoplasmic and irregularly distributed throughout the tumor tissue. Electron microscopic examination revealed various types of secretory granules, including atypical giant crystalloid protogranules in one case, and the postembedding PAP procedure showed labeling of all types of granules. Acid phosphatase staining was observed within secretory granules and autophagic vacuoles. The process of renin storage and release is discussed. The presence in one case of a neural component and a distal tubular structure supports the view of a hamartomatous lesion.

Adult↗

Osmoregulation and renal effects of vasopressin in normal and mildly hypertensive subjects.

A 2-hr 0.85 M hypertonic saline infusion was administered to ten normotensive volunteers and ten mildly hypertensive subjects to compare in these two groups the osmoregulation of vasopressin and the effect of this hormone on BP. No significant alteration in BP was observed in either group, despite markedly enhanced vasopressin levels. Significant positive correlations between plasma vasopressin (AVP) and plasma osmolality (POsm) were demonstrated in the controls (AVP = -70 + 0.25 POsm, r = 0.68, P less than 0.0001) and in the hypertensive group (AVP = -46 + 0.16 POsm, r = 0.59, P less than 0.0001). However, the vasopressin response to the osmotic stimulus was buffered in the hypertensive subjects; the slope of the regression line between plasma vasopressin and plasma osmolality was less steep in hypertensive subjects than in normotensive subjects (0.16 vs. 0.25, P less than 0.018). During the saline infusion the renal parameters were identical in the two groups. Finally, in mild hypertension, the osmoregulation of vasopressin was preserved but buffered and renal sensitivity to this hormone was normal. An osmotically induced physiological increase in vasopressin did not raise BP in either normotensive or mildly hypertensive subjects.

Adult↗

Enzymatic activity of renin in plasma of normal and uraemic subjects.

Plasma renin reactivity (PRR) is the rate of angiotensin I production after addition of renin to plasma, minus endogenous renin activity. PRR is increased in plasma of patients with renal failure compared with that of normal subjects. The present study was carried out to determine if increased PRR in uraemic plasma is related to differences of endogenous active or inactive renin, endogenous renin substrate, or pH of the incubation in vitro. PRR in plasma of ten uraemic patients was greater (P less than 0.02) than that in plasma of ten normal subjects in incubations carried out at pH 7.4 and 5.7. Increased PRR was not accounted for by differences of endogenous active and inactive renin activity. After addition of renin, renin concentration (measured by direct radioimmunoassay) did not differ in normal and uraemic plasma. Renin substrate concentration, measured both indirectly and by direct radioimmunoassay, also did not differ in normal and uraemic plasma. Increased PRR in uraemic plasma is not related to alterations of renin or renin substrate concentrations. These observations are consistent with our earlier hypothesis that there is a deficiency of a renin inhibitor in uraemic plasma.

Angiotensinogen↗

Synthesis of peptides related to the prosegment of mouse submaxillary gland renin precursor: an approach to renin inhibitors.

The complete sequence of the structural gene coding for mouse submaxillary gland renin was recently reported and the amino acid sequence of preprorenin was deduced. This sequence includes a 45-amino acid peptide that corresponds to the prosegment of the renin precursor. To investigate whether peptides related to the renin prosegment are able to inhibit renin activity, we have synthesized four peptides having the following structures: Arg-Ile-Pro-OMe, butyloxycarbonyl(Boc)-Leu-Lys-Lys-Met-Pro-OMe, Boc-Arg-Ile-Pro-Leu-Lys-Lys-Met-Pro-OMe, and Boc-Glu-Arg-Ile-Pro-Leu-Lys-Lys-Met-Pro-OMe (corresponding to amino acids 12-14, 15-19, 12-19, and 11-19, respectively, of the renin prosegment). All four peptides were found to inhibit the activity of pure mouse submaxillary renin on a porcine synthetic tetra-decapeptide in vitro, and the most potent inhibitors exhibited IC50 values in the micromolar range. Enzymatic kinetic studies carried out using peptide 15-19 showed an uncompetitive or a mixed type of inhibition with a Ki value of 2.3 X 10(-6) M at 37 degrees C in 0.5 M citrate/phosphate buffer (pH 6.0).

Amino Acid Sequence↗

Potentials and limitations of angiotensin converting enzyme inhibition in the treatment of hypertension.

To appreciate the advantages of inhibiting the renin-angiotensin system in the treatment of hypertension it is necessary to be aware of four major failures in today's therapy of the disease: The theoretical blood pressure target (supine diastolic blood pressure of 90 to 95 mmHg) is not reached in every patient. The number of adverse effects affecting the quality of life is not acceptable. Today's antihypertensive medications have no basic physiological rationale. Although the mechanical risks of blood pressure elevation are avoided with today's therapy, coronary heart disease, the most common cardiac complication, is not significantly reduced. Converting enzyme inhibition could theoretically provide a solution to each of these failures but its advantages will have to be balanced against the potential risks. The risk of iatrogenic disease with any compound introduced chronically into a living organism for therapeutic reasons. The lack of substrate specificity and the unknown overall physiological effect of angiotensin converting enzyme.

Angiotensin-Converting Enzyme Inhibitors↗

Sudden unexpected infant death in a French county.

We report a study of sudden unexpected infant death (SUID) in a French county (Seine-Maritime) between 1978 and 1981 (rate of 2.71 per 1000 live births). The results agree with those of previous studies concerning sex ratio, seasonal variation, and peak age of death. No relation between gestational age and age of death was found. A comparison with matched living control infants was performed for 136 of the 207 total deaths for whom computerised medical data were available. Significant differences were found between these two groups in gestational age, birthweight, admission to a paediatric ward at birth, and proportion of single mothers. In analysing birthweight and gestational age separately, the birthweights of SUID cases were significantly lower than those of controls, whatever the gestational age. The converse was not true, however: in classifying infants by birthweight, a significant difference between the gestation period of SUID victims and controls was found only for low birthweight infants (less than 2500 g). It is considered that it may be possible to identify infants at particular risk of SUID within the group of babies admitted to hospital at birth for major problems, and a study is currently underway among infants born in Seine-Maritime in 1982.

Age Factors↗

Influence of converting-enzyme inhibition on rat des-angiotensin I-angiotensinogen.

The effects of high plasma renin levels on plasma levels of both total immunoreactive angiotensinogen (direct radioimmunoassay) and intact angiotensinogen measured by angiotensin I released by renin (indirect assay) were studied in sodium-depleted rats both with and without captopril treatment and in adrenalectomized rats. The direct assay measures both intact angiotensinogen and des-angiotensin I-angiotensinogen, its residue cleaved by renin. The indirect assay measures only intact angiotensinogen. Neither sodium depletion, captopril treatment, nor adrenalectomy modified the circulating levels of total angiotensinogen. However these treatments produced a decrease in intact angiotensinogen that was in proportion to the elevation of renin levels. The difference between the two assays for angiotensin represents the level of des-angiotensin I-angiotensinogen and correlated satisfactorily with the plasma levels of renin. Identical correlations were observed in adrenalectomized rats and captopril-treated rats. We conclude that des-angiotensin I-angiotensinogen levels are an index of activation of the renin-angiotensin system dependent on the circulating level of renin.

Adrenal Glands↗

Blood pressure effects of renin inhibition by human renin antiserum in normotensive marmosets.

The effects on blood pressure of an antiserum against pure human kidney renin were studied in conscious and anesthetized (pentobarbital, 24 mg X kg-1 i.p.) small new world monkeys (common marmosets). The antiserum inhibited the enzymatic activity of renin by 50% in a dilution of 1:45,000 in marmoset and 1:50,000 in human plasma. The antiserum (0.2 ml i.v.) decreased blood pressure in conscious marmosets on normal sodium intake by 15 +/- 5 (SD) mmHg and after salt depletion by 31 +/- 13 mmHg. A converting enzyme inhibitor (teprotide, 2 mg X kg-1 i.v.) induced a comparable fall in blood pressure: -16 +/- 10 and -30 +/- 10 mmHg, respectively. Similar effects were observed on blood pressure of anesthetized marmosets. The correlation between pretreatment plasma renin concentration and the maximum fall in blood pressure was significant and identical for the experiments with antiserum and teprotide. These results demonstrate that antisera against human renin can be used for the specific blockade of the renin-angiotensin system in primates. In normotensive marmosets the renin-angiotensin system participates in the maintenance of blood pressure, to a degree depending on the state of sodium balance.

Anesthesia, General↗

Renin biosynthesis by human tumoral juxtaglomerular cells. Evidences for a renin precursor.

Renin biosynthesis was studied in a juxtaglomerular cell tumor. The tumoral tissue had a high renin content (180 Goldblatt Units/g of tissue), was heavily stained by immunofluorescence using human renin antiserum, and exhibited numerous characteristic secretory granules by electron microscopy. In one series of experiments, renin biosynthesis was studied in tissue slices, by following the incorporation of radiolabeled amino acids into specific immunoprecipitable renin. Time course studies showed that renin was first synthesized in a high molecular weight form, 55,000 mol wt, i.e., 10,000 mol wt higher than that of active renin, and was then converted into a 44,000-mol wt form. In a second series of experiments renin tumoral cells were cultured. Small, round, birefringent cells obtained after collagenase digestion produced renin in both primary culture and subculture media. After 5 d most of the renin found in the culture medium was inactive, but could be activated by trypsin treatment. The tumoral tissue exhibited a strong renin immunofluorescence and numerous secretory granules were observed by electron microscopy. In contrast, the renin-producing cells isolated from this tumor and grown in culture showed little renin immunofluorescence and no secretory granule could be observed. The renin-producing cells in primary culture and subculture were pulsed with radiolabeled amino acids, and immunoprecipitable radiolabeled renin was found in the culture media, thus demonstrating the actual biosynthesis of the enzyme. This renin was not stored inside cultured cells but was rapidly released into the medium and had a molecular weight of 55,000. No conversion of this inactive high molecular weight renin into the active, 44,000 mol wt form of renin was observed. We postulate the existence of two pathways for the processing, packaging, and secretion of renin in the tumoral cells: in juxtaglomerular cells of tumoral tissue renin is synthesized as a preprorenin and rapidly converted into prorenin (55,000 mol wt), which is in turn packaged in secretory granules where it is processed into active renin (44,000 mol wt) and finally secreted; in the cultured tumoral cells renin is still biosynthesized as a preprorenin molecule and then converted into prorenin, but is neither stored as granules nor processed into active renin. In this case the renin is released in an inactive form.

Adult↗

New monoclonal antibodies directed against human renin. Powerful tools for the investigation of the renin system.

Monoclonal antibodies directed against human renin were obtained by the fusing of myeloma cells with spleen cells from Balb/c or high-responder Biozzi mice injected with pure tumoral or highly purified renal renin. These procedures resulted in the production of seven stable monoclonal antibodies to human renin. Antibodies in the hybridoma culture medium were screened by binding to pure iodinated renin or insolubilized renin in a solid phase assay. The concentration of purified antibodies that provided a 50% binding to iodinated renin varied from 1 X 10(-10) to 1 X 10(-7) M. Two monoclonal antibodies were found to be potent inhibitors of renin enzymatic activity in vitro, behaving as noncompetitive inhibitors (Ki, 1 to 4 X 10(-10) M). They were specific for primate renin. Three monoclonal antibodies provided suitable immunoadsorbants for renin purification. One of these immunoadsorbants was used for large-scale purification of the renal enzyme, resulting in an 825-fold renin enrichment in a single step. Two antibodies were able to distinguish between active and inactive renin and enabled concomitant separation and purification of the two enzyme forms in various biological fluids. Monoclonal antibodies also stained human and monkey renal renin when indirect immunofluorescence and peroxidase-antiperoxidase techniques were used. A highly sensitive radioimmunometric assay of renin was constructed with two monoclonal antibodies. The sensitivity of this improved assay should permit the detection of renin in normal human plasma. Monoclonal antibodies have been shown to be superior to polyclonal antibodies in the following areas: the separation of active from inactive renin, the purification of renin from biological fluids, and the setting up of a direct assay of plasma renin.

Amniotic Fluid↗

Characterization of precursor and secreted forms of rat angiotensinogen.

Angiotensinogen precursors synthesized by rabbit reticulocyte lysate primed with rat liver RNA were compared with angiotensinogen secreted by rat hepatoma cells and rat hepatocytes using immunoprecipitation and sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Inhibition of glycosylation with tunicamycin permitted identification of the nonglycosylated form of secreted angiotensinogen. Whereas angiotensinogen secreted by hepatoma cells and hepatocytes showed electrophoretic heterogeneity (mol wt, 52-62 X 10(3], tunicamycin-treated cells secreted only a single angiotensinogen species [mol wt, 48.3 +/- 0.7 X 10(3) (mean +/- SD)], which could be cleaved by renin. Two putative angiotensinogen precursors were synthesized in the reticulocyte lysate: a major protein of 52.5 +/- 1.0 X 10(3) mol wt and a minor protein of 55.7 +/- 1.3 X 10(3) mol wt. Evidence that these proteins represent separate angiotensinogen precursors includes the following. 1) Both proteins were recognized by five different polyclonal antibodies and two monoclonal antibodies. 2) Both proteins increased in parallel in reticulocyte lysates primed with liver RNA from rats nephrectomized and given hormones that increase liver angiotensinogen production. 3) Both proteins were cleaved by renin to produce a single protein of 47.6 +/- 0.8 X 10(3) mol wt. 4) The des-angiotensin I-angiotensinogen generated by renin treatment of the lysate had an electrophoretic mobility identical to that of des-AI-angiotensinogen produced by renin treatment of nonglycosylated angiotensinogen secreted by tunicamycin-treated hepatoma cells and hepatocytes. These studies suggest that rat liver synthesizes two separate angiotensinogen precursors which may differ only in the size of their prepro sequence. The heterogeneity of secreted angiotensinogen can be fully accounted for by differences in N-glycosylation of asparagine residues of the molecule. Glycosylation of angiotensinogen is not essential for its synthesis, processing, and secretion or its hydrolysis by renin.

Angiotensinogen↗

Characterization of plasma and cerebrospinal fluid human angiotensinogen and des-angiotensin I-angiotensinogen by direct radioimmunoassay.

Angiotensinogen and the product of its hydrolysis by renin, des-angiotensin I-angiotensinogen, were quantitated in human plasma and in cerebrospinal fluid (CSF) by a direct RIA. This assay was developed using polyclonal antibodies raised against pure human angiotensinogen. The antibodies recognized only primate angiotensinogen and des-angiotensin I-angiotensinogen. Results obtained with the direct RIA were compared with those of the indirect assay which measures angiotensinogen through angiotensin I liberated by an excess of renin. Both assays gave almost identical results in normal subjects whereas in three different conditions characterized by a high renin level (severe hypertension plus low sodium diet, converting enzyme inhibition, and adrenal insufficiency) higher results were obtained by the direct assay. This difference between the results of both methods was attributed to des-angiotensin I-angiotensinogen accumulation which is detected only in the direct assay. CSF angiotensinogen had similar immunochemical properties to plasma angiotensinogen and could also be measured by the direct RIA. Isoelectric focusing of plasma angiotensinogen and des-angiotensin I-angiotensinogen revealed a similar microheterogeneity. Microheterogeneity was also a characteristic of CSF angiotensinogen, but its isoelectric point was more basic than plasma angiotensinogen.

Angiotensin I↗

Antisera to human renin normalize renin-dependent hypertension in the monkey: therapeutic implications.

Polyclonal antisera raised against pure human renin normalize renin-dependent blood pressure elevation in the monkey (M. fascicularis). In vitro, comparable inhibition of either human or monkey plasma renin by the antisera was demonstrated. In vivo, intravenous infusion of 2 ml of antisera did not change mean arterial pressure of salt-repleted monkeys, however, its administration to salt-depleted monkeys with elevated plasma renin activity lowered mean arterial pressure 10 Torr. A 25 Torr rise in mean arterial pressure and increase in plasma renin activity occurred promptly after inflation of a suprarenal aortic cuff in conscious uninephrectomized monkeys. Administration of 2 ml of antisera to these monkeys normalized mean pressure, which was reduced by an additional 10 Torr if the animals were previously salt-depleted. Maximal hypotension occurred within 1 hour and was sustained for approximately 10 hours. Because of the differing specificities of polyclonal antisera, sera raised in two laboratories against human renin purified from different sources were employed. Identical results were obtained. This is the first demonstration of the use of antisera to inhibit endogenous renin activity in primates and predicts the in vivo efficacy of renin antisera as experimental, diagnostic and therapeutic agents.

Animals↗

Angiotensin I-converting enzyme in amniotic fluid.

Angiotensin I-converting enzyme (ACE) is present in human amniotic fluid. We characterized the enzyme by both its antigenic and enzymatic properties. Using a specific direct radioimmunoassay, ACE was quantified and characterized in each of the 19 samples tested. Mean level was 136 +/- 83 ng/ml. Amniotic ACE completely crossreacted, like that in plasma and kidney, with antibodies raised against the lung enzyme. ACE activity in amniotic fluid averaged 8.7 +/- 5.6 microU/ml using Hip-His-Leu as substrate and was significantly correlated with ACE antigen levels. ACE was not associated with the cells or the free intracellular organelles in amniotic fluid, and the enzyme was present in soluble form. Angiotensinase activity and high levels of kininase activity were found in amniotic fluid. Inhibition studies with captopril and anti-human ACE antibodies suggest that angiotensinases and kininases other than ACE were also present. Because renin, mostly in inactive form, and angiotensinogen were also found in these amniotic fluids, it appears that a complete, although not fully activated, renin angiotensin system is present in amniotic fluid and fetal membranes during pregnancy.

Adult↗

Factors predictive of attendance at clinic and blood pressure control in hypertensive patients.

Poor compliance with appointments and drug treatment is one of the recognised factors preventing effective management of hypertension. Factors predictive of poor attendance and inadequate blood pressure control in patients attending a hypertension clinic were therefore determined using univariate analyses and a multivariate logistic model. Out of 1346 patients with blood pressure exceeding 160/95 mm Hg followed up for three years, 209 (15.5%) dropped out during the first year. Variables that were significantly related to increased drop out rates were male sex, young age, obesity at entry, cigarette smoking, direct referral to the clinic as a result of screening instead of referral by a general practitioner, absence of pre-existing antihypertensive treatment at the first visit, moderate hypertension, and low socioeconomic category. Variables at entry that were significantly related to poor blood pressure control at one year were old age, evidence of coronary heart disease, severe hypertension, and raised blood glucose concentrations. Early detection of patients at high risk of drop out or poor blood pressure control might improve treatment of hypertension and allow management to be more individually adapted to each patient.

Adult↗