Diagnostic Use of Urinary Thromboxane B2
Although radioimmunoassy (RIA) for prostaglandins has been employed for a decade, the clinical diagnostic use of any of the arachidonic acid metabolites has not been described until recently . The discovery by Fichman et al.  that patients with Bartter’s Syndrome had elevated plasma and urine prostaglandins concentrations encouraged many nephrologists, including ourselves , to take an interest in the clinical utility of such prostaglandin measurements. The clinical diagnosis of Bartter’s Syndrome, however, is not based on prostaglandin analyses, and consequently there is no requirement for the assay other than for the purpose of diagnostic confirmation. We have, for the first time, found potential diagnostic validity for one of the arachidonic acid metabolites, namely,thromboxane B2 (TXB2). This compound is a stable product of thromboxane A2 (TXA2) which is chemically labile with a half-life at pH 7.4 of 30 sec . Thromboxane B2 has little biological activity, but large doses reduce the inactivation of PGE2 by pulmonary transit in dogs . In contrast TXA2 is a powerful spasmogenic agent on all four classes of smooth muscle and aggregates both platelets and leukocytes which implies that TXA2 is likely to have a deleterious effect on the microcirculation.
KeywordsDeep Venous Thrombosis Allograft Rejection Rejection Episode Arachidonic Acid Metabolite Kidney Transplant Patient
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