Introduction
Why biomarkers?
Scope of this review
BNP
Discovery and structure of BNP
Stimulus, production and processing
Mechanism of action
Degradation and elimination
As a marker for heart failure
BNP monitoring
Assays
Commercial diagnostic tests | Capture antibody | Detection antibody | Standard material | FDA cleared yes/no/claim |
---|---|---|---|---|
Abbott Architect, AxSYM iSTAT | NH2 terminus and part of the ring structure (Scios), murine monoclonal AB, aa 5–13 | COOH terminus, murine monoclonal AB, aa 26–32 | Synthetic BNP 32 | Assist in diagnosis of HF Assess severity of disease |
Alerea
Triage BNP | NH2 terminus and part of the ring structure (Scios), murine monoclonal AB, aa 5–13 | BNP (Biosite), murine omniclonal AB, epitope not characterized | Recombinant BNP | Aid in diagnosis and severity assessment of HF Risk stratification of patients with ACS and HF FDA cleared |
Beckman Coultera
Access, Access 2, DxI | BNP (Biosite), murine omniclonal AB, epitope not characterized | NH2 terminus and part of the ring structure (Scios), murine monoclonal AB, aa 5–13 | Recombinant BNP | Diagnosis HF Assess severity HF Risk ACS Risk HF |
Siemens (Bayer) ACS 180, Advia Centaur, Advia Centaur CP | COOH terminus (BC-203) (Shionogi), murine monoclonal AB, aa 27–32 | Ring structure (KY-hBNPII) (Shionogi), murine monoclonal AB | Synthetic BNP | Aid in diagnosis and severity assessment of HF Predict survival and likelihood of future HF in ACS patients |
Siemens (Dade Behring) Dimension VISTA Dimension ExL | Ring structure (KY-hBNPII) murine monoclonal AB, aa 14–21 | COOH terminus (BC-203), murine monoclonal AB, aa 27–32 | Synthetic BNP 32 | Aid in diagnosis and severity assessment of HF Predict survival and likelihood of future HF in ACS patients Pending FDA clearance |
Shionogi | COOH terminus (BC-203), murine monoclonal AB, aa 27–32 | Ring structure (KY-hBNPII), murine monoclonal AB | Synthetic BNP | Not FDA cleared |
Tosoh ST AIA-PACK BNP | COOH terminus (BC-203), murine monoclonal AB, aa 27–32 | Ring structure (KY-hBNPII), murine monoclonal AB | Synthetic BNP | Not FDA cleared |