NT-proCNP ELISA, 2nd generation
|Method:||Sandwich ELISA, HRP/TMB, 12x8-well strips|
|Sample type:||Serum, plasma|
|Standard range:||0-128 pmol/l (7 lyophilized standards)|
|Standard points:||0/4/8/16/32/64/128 pmol/l|
|Sample size:||20 µl / well|
|Incubation time:||20 min / 3 h / 30 min|
|Unit conversion:||1 pg/ml = 0.201 pmol/l (MW: 4.985 kDa)|
LOD: 0.7 pmol/l (0 pmol/l + 3 SD)
Intra-assay (n=5) ≤ 6%, Inter-assay (n=8) ≤ 7%
Values from apparently healthy individuals:
Median (serum, n=32) = 14.5 pmol/l
Median (EDTA plasma, n=33) = 15 pmol/l
Median (Heparin plasma, n=18) = 13.5 pmol/l
Median (Citrate plasma, n=18) = 12 pmol/l
It is recommended to establish the normal range for each laboratory.
Principle of the assay:
Manual ELISAs - easily adaptable for automation!
INSTRUCTIONS FOR USE
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C–type natriuretic peptide (CNP) is a paracrine growth factor widely expressed in tissues, including the vascular endothelium, where it is considered to provide vasoprotective functions. In endothelial cells and macrophages it is secreted in response to several stimuli, including inflammatory mediators. CNP is rapidly degraded in tissues and negligible quantities enter the circulation. However, the N-terminal portion of the pro-hormone is not degraded at source and circulates in significantly higher concentrations than CNP. Therefore NT-proCNP is a valuable biomarker to determine CNP synthesis in tissues. CNP plays a critical role in linear growth. It is produced in the growth plate and signals through a paracrine mechanism. Recent studies have shown that the plasma concentrations of NT-proCNP correlate with linear growth velocity in all phases of skeletal growth and increase during rhGH therapy (1). Furthermore, serum NT-proCNP levels increased after initiation of GH treatment in patients with achondroplasia/ hypochondroplasia (2). Women with pregnancy complications, such as diminished fetal growth and pre-eclampsia show significantly increased NT-proCNP levels early in gestation (3, 4). NT-proCNP concentration at hospital admission has sufficient sensitivity and specificity to differentiate naturally occurring sepsis from non-septic systemic inflammatory response syndrome (SIRS) (5, 6). Recently, Prickett and colleages demonstrated in a cohort of over 2000 individuals, that in contrast to the close association of NT-proBNP with cardiac function, and predictive value for outcome after myocardial infarction, plasma NT-proCNP is highly correlated with renal function and is an independent predictor of mortality and cardiac readmission in individuals with unstable angina (7).
1. Dynamic response of C-type natriuretic peptide and its aminoterminal propeptide (NTproCNP) to growth hormone treatment in children with short stature. Olney RC et al., Clin Endocrinol 2016; 85(4):561-568.
2. Serum NT-proCNP levels increased after initiation of GH treatment in patients with achondroplasia/hypochondroplasia. Kubota T et al., Clin Endocrinol (Oxf) 2016; 84(6):845-850.
3. C-type natriuretic peptide in complicated pregnancy: increased secretion precedes adverse events. Reid RA et al., J Clin Endocrinol Metab 2014; 99(4):1470-1478.
4. Effects of pre-eclampsia and fetal growth restriction on C-type natriuretic peptide. Espiner, E A et al., BJOG 2015; 122, 1236–1243.
5. Prognostic value of circulating amino-terminal pro-C-type natriuretic peptide in critically ill patients. Koch et al., Critical Care 2011; 15:R45.
6. The prognostic value of concomitant assessment of NT-proCNP, C-reactive protein, procalcitonin and inflammatory cytokines in septic patients. Tomasiuk R et al., Crit Care 2014; 25;18(3):440.
7. C-Type Natriuretic Peptides in Coronary Disease. Prickett TCR et al., Clin Chem, 2017; 63(1):316-324.
8. The natriuretic peptides system in the pathophysiology of heart failure: from molecular basis to treatment. Volpe M et al., Clinical Science, 2016; 130:57-77.
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