Analysis of B-Type Natriuretic Peptide Molecular Diagnostics Study

This case study delves into the molecular diagnostics of B-type natriuretic peptide (BNP), a cardiac hormone crucial for identifying heart failure. While the FDA has approved BNP diagnostic tests using Mass Spectrometry Immunoassay (MSIA), research indicates potential inaccuracies due to the assessment of both inactive pro-BNP and mature BNP 1-32. The study emphasizes the importance of mature BNP 1-32 as a biomarker for acute heart failure and its role in understanding left heart ventricles' systolic and diastolic function. It suggests improvements such as utilizing protease inhibitors during blood sample collection and treating samples with antigens marked with active BNP markers. The case study concludes by advocating for the use of MSIA and similar non-FDA approved tests to validate BNP biomarker test results, ultimately enhancing the accuracy of heart failure diagnosis and treatment efficacy monitoring. Desklib provides access to this and other solved assignments.

Running head: MOLECULAR DIAGNOSTICS
MOLECULAR DIAGNOSTICS ASSIGNMENT
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1MOLECULAR DIAGNOSTICS
B-type natriuretic peptide, also known as the Brain natriuretic peptide (BNP) is the
cardiac hormone which is generated or secreted by the cardiomyocytes within the ventricles of
heart (Halfinger et al., 2017). Increased ventricular blood volume or pressure associated with
stretching of heart muscles leads to the expression of this hormone, and hence, it is easier to
understand heart failure form the diagnosis of overexpression of this hormone in human body
(Maalouf & Bailey, 2016). However, through the research conducted by Niederkofler et al.
(2008), it was observed that the diagnosis test for expression of BNP within patients with heart
disorder did not produce accurate results and there were faults in identification of the amount of
cardiac hormone released in the body during heart failure. Despite this fact, the Food and Drug
Administration (FDA) has approved this diagnosis test for the identification of BNP through the
process of Mass Spectrometry Immunoassay or MSIA.
However, it was determined through researches that BNP is an important and sensitive
biomarker which is required in the determination of acute heart failure, besides which it also
helps to understand the systolic and diastolic function of the left heart ventricles. Further, it was
also observed that BNP works as a complex and universal biological marker for patients affected
with heart failure and in neonatal health conditions as well, it helps to identify the rate of
morbidity and mortality. Alongside this, BNP significantly narrows the diagnosis process and
due to this healthcare professionals are able to understand the difference between dyspnea due to
heart failure condition, compared to dyspnea occurring due to other health complications which
occurs to elevated BNP level and normal BNP level respectively. Finally, in patients who are
affected with severe heart failure and associated condition, BNP marker helps to understand the
efficacy of the treatment process as effective treatment for heart failure associated condition is
expected to decrease the level elevated BNP concentration within the patient. Therefore, despite

2MOLECULAR DIAGNOSTICS
having issues regarding its effectiveness, its accuracy and other concerns, FDA approved this
diagnosis process so that identification of heart failure condition could be observed.
From the research of Niederkofler et al. (2008), it was observed that while identification
of elevated BNP levels within patients suffering from heart failure, the assessment ends up
recognizing two type of BNPs which are inactive pro-BNP and the mature BNP 1-32, whereas
the assessment is expected to assess the level of mature BNP 1-32 for the identification of heart
failure associated condition within patients. Hence, there should be a strategy using which the
identification of inactive pro-BNP could be minimized or eliminated (Maalouf & Bailey, 2016).
Therefore, to improve the conditions, protease utilizers should be utilized while collecting blood
samples from the patients and it should be treated with antigens marked with active BNP
markers so that active antibodies associated to active BNPs could be identified and utilized for
the identification of heart failure conditions in patients (Semenov & Katrukha, 2016). Further,
MSIA or the Mass Spectrometry Immunoassay and the similar non-FDA approved diagnostic
tests should be performed by the healthcare facilities to assure the results obtained from the BNP
biomarker tests.

3MOLECULAR DIAGNOSTICS
References
Halfinger, B., Hammerer-Lercher, A., Amplatz, B., Sarg, B., Kremser, L., & Lindner, H. H.
(2017). Unraveling the Molecular Complexity of O-Glycosylated Endogenous (N-
Terminal) pro–B-Type Natriuretic Peptide Forms in Blood Plasma of Patients with
Severe Heart Failure. Clinical chemistry, 63(1), 359-368.
Maalouf, R., & Bailey, S. (2016). A review on B-type natriuretic peptide monitoring: assays and
biosensors. Heart failure reviews, 21(5), 567-578.
Niederkofler, E. E., Kiernan, U. A., O'Rear, J., Menon, S., Saghir, S., Protter, A. A., ... &
Schellenberger, U. (2008). Detection of endogenous B-type natriuretic peptide at very
low concentrations in patients with heart failure. Circulation: Heart Failure, 1(4), 258-
264.
Semenov, A. G., & Katrukha, A. G. (2016). Analytical issues with natriuretic peptides–has this
been overly simplified?. EJIFCC, 27(3), 189.