[The efficacy and tolerance of orally administered kallikrein in patients with essential arterial hypertension].
Since the reduced kallikrein excretion demonstrated in essential hypertension suggested the possibility of an impairment in the renal kallikrein-kinin system, we decided to evaluate the efficacy and safety of oral kallikrein administration (glandular kallikrein derived from porcine pancreas) in 30 essential hypertensive subjects (21 males, 9 females, age range 34-62 years). Twenty subjects took 150 IU kallikrein t.i.d. for eight days; during this period their sodium intake remained normal (120 mEq Na+/die). Ten subjects took placebo. After the trial period, urinary kallikrein in the active group increased from 0.9 +/- 0.4 U/24 h (normal value greater than 1.2 U/24 h) to 1.6 +/- 1 U/24 h (p less than 0.05); systolic and diastolic blood pressure decreased respectively from 154.6 +/- 13.8 mmHg to 140.3 +/- 12.5 mmHg (p less than 0.01) and from 92.5 +/- 1.5 mmHg to 86 +/- 3.9 mmHg (p less than 0.025); urinary sodium and potassium excretion increased respectively from 96.7 +/- 17 mEq/24 h to 119.1 +/- 32.3 mEq/24 h (p less than 0.05) and from 36.7 +/- 11 mEq/24 h to 43.5 +/- 12.8 mEq/24 h (p less than 0.05). One patient in the kallikrein group suffered a transient episode of gastric pain. No modifications of the parameters evaluated were observed in the placebo group. We conclude that kallikrein has a mild hypotensive effect in hypertensive subjects and is generally well-tolerated. Its antihypertensive effect is probably due to the sodiuretic action of the substance.
Bellini
C
C
Istituto di I Clinica Medica, Università degli Studi di Roma La Sapienza.
Carlomagno
A
A
Piccoli
A
A
Di Francesco
L
L
Torregrossa
G
G
Leonetti Luparini
R
R
Germanò
G
G
Giarrizzo
C
C
Ferri
C
C
Santucci
A
A
D000284:Administration, Oral; D000328:Adult; D001794:Blood Pressure / Q000187:drug effects; D004231:Diuresis / Q000187:drug effects; D004341:Drug Evaluation; D004361:Drug Tolerance; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology / Q000652:urine; D007610:Kallikreins / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008875:Middle Aged
D007610:Kallikreins
Efficacia e tollerabilità della somministrazione orale di callicreina in pazienti affetti da ipertensione arteriosa essenziale.