Research progress of circulatory truncated B-type natriuretic peptides
王乔 1肖鹏 2冯丽娜 3任景怡 4唐栋
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作者信息
1. 北京中医药大学研究生院，北京 100029
2. 中国计量科学研究院，北京 100029
3. 北京大学中日友好临床医学院，北京 100029
4. 中日友好医院心脏科（心衰中心），北京 100029
折叠
摘要
心力衰竭（心衰）患病率及死亡率逐年增加，在全球范围内都导致巨大的医疗和经济负担。B型利钠肽（BNP）是心衰生物标志物的“金标准”，多部指南推荐其用于心衰的诊断及预后评估。近年来研究发现心衰中BNP并非以完整片段形式存在，可被不同酶降解产生不同截短形式，对心衰的诊断和分型等具有临床鉴别意义。临床常用的传统免疫分析法由于抗体的交叉反应无法区分不同的BNP截短形式，而采用质谱分析法通过不同质荷比易于区分并确定不同截短形式，是精准检测BNP截短形式的方法。同时，随着敞开式质谱、离子淌度质谱等技术的成熟，将有助于降低血样前处理的复杂度并提高BNP片段的分离效率，进而深入探究BNP截短形式异质性的临床价值。 The incidence and mortality rate of heart failure (HF) are increasing annually, resulting in a huge medical and economic burden worldwide. B-type natriuretic peptide (BNP) is the gold standard biomarker of HF recommended by national and international guidelines for the diagnosis and prognosis evaluation of HF. Recent studies suggest that BNP can be truncated in multiple forms by different enzymes rather than complete fragments in circulation, which can be contributing to the diagnosis and classification of HF. The immunoassay mostly used in clinics are unable to distinguish different truncated BNP forms due to cross-reactivity of antibody, while mass spectrometry is more accurate because it can easily distinguish through their mass-to-charge ratios. With the maturation of ambient ionization mass spectrometry and ion mobility mass spectrometry, it can help to simplify sample pre-treatment and improve the separation efficiency, in order to explore the clinical value of the heterogeneity of BNP truncated forms.
Abstract
The incidence and mortality rate of heart failure (HF) are increasing annually, resulting in a huge medical and economic burden worldwide. B-type natriuretic peptide (BNP) is the gold standard biomarker of HF recommended by national and international guidelines for the diagnosis and prognosis evaluation of HF. Recent studies suggest that BNP can be truncated in multiple forms by different enzymes rather than complete fragments in circulation, which can be contributing to the diagnosis and classification of HF. The immunoassay mostly used in clinics are unable to distinguish different truncated BNP forms due to cross-reactivity of antibody, while mass spectrometry is more accurate because it can easily distinguish through their mass-to-charge ratios. With the maturation of ambient ionization mass spectrometry and ion mobility mass spectrometry, it can help to simplify sample pre-treatment and improve the separation efficiency, in order to explore the clinical value of the heterogeneity of BNP truncated forms.
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