The utilization of c-type natriuretic peptide levels on experimental muscle and kidney ischemia/reperfusion model

Özlem Çakırköse¹, Uğur Kesici²*, Sevgi Kesici³, Mehmet Sipahi⁴, Vehbi Yavuz Tokgöz⁵, Gülname Fındık Güvendi⁶, Esin Avcı⁷, Tuğba Mazlum Şen⁸, Hanife Kara⁹, Alptekin Tosun¹⁰, Mustafa Nezihi Küçükarslan¹¹

1. Giresun University, Medical Faculty, Department of Cardiovascular Surgery, Giresun, Türkiye
2. Health Science University, Prof. Dr. Cemil Tascioglu City Hospital, Department of General Surgery
3. Health Science University, Hamidiye Etfal Training and Research Hospital, Department of Anesthesiology and Reanimation, Istanbul, Türkiye.
4. Giresun University, Medical Faculty, Department of Gynecology and Obstetrics, Giresun, Türkiye
5. Osmangazi University, Medical Faculty, Department of Gynecology and Obstetrics, Eskisehir, Türkiye
6. Recep Tayyip Erdoğan University, Medical Faculty, Deparment of Pathology, Rize, Türkiye
7. Giresun University, Medical Faculty, Department of Statistics, Giresun, Türkiye
8. Karadeniz Technical University, Department of Biochemistry, Trabzon, Türkiye
9. Serafettin Sabuncuoglu Training and Research Hospital, Department of Biochemistry, Amasya, Türkiye.
10. Giresun University, Medical Faculty, Department of Radiology, Giresun, Türkiye
11. Varis Clinic, Department of Cardiovascular Surgery, Ankara, Türkiye.

*Corresponding Author: Ugur Kesici; E-mail:ugurkesici77@mynet.com

Abstract
Introduction
C-type Natriuretic Peptide (CNP) is the third natriuretic peptide (NP) identified from the nervous system and endothelial cells. CNP is believed to be produced locally in tubular cells and glomeruli of kidneys. We aim to determine the clinical value of CNP levels at lower extremity muscle ischemia/reperfusion (I/R), kidney I/R, and both I/R models and evaluate them in laboratory practices.
Method
This study is an original experimental study and was carried out on a total of 40 rats. (8-12 weeks and 321±69 gr). The rats were assigned into 5 groups, each containing 8 rats. CNP levels in the plasma were evaluated in the control group. CNP and muscle biopsies were held after ischemia/reperfusion from the left lower extremity in Group E and bilateral muscle ischemia/reperfusion in Group BE. CNP and renal biopsies were held after right nephrectomy+left renal I/R at Group R. CNP, muscle, and renal biopsies were held after right nefrectomy+left renal ischemia+bilateral renal ischemia in Group BER.
Results
The plasma level of CNP in the control group was determined as 144.99±33.04 pg/ml. There was no significant difference between groups at plasma CNP levels in predicting ischemia. Although in terms of reperfusion between Control-Group E, Control-Group BER, Group E-Group BE, Group E-Group R, Group BE-Group BER, Group R-Group BER; statistical significance was determined (p<0.05).
Conclusion
This study suggests that as a laboratory test, the endothelial-derived vasodilator CNP level cannot predict the location and degree of muscle and renal ischemia at the specified time. Similarly, the CNP level is valuable in evaluating adjunct muscle reperfusion to renal reperfusion. As a result, CNP levels may not be useful in predicting ischemia at a particular period, but they can be used to predict reperfusion.