Use of polyamine metabolites as markers for stroke and renal failure.

Acrolein and H(2)O(2) are among the metabolic products of spermine and spermidine, and it was found that acrolein was more toxic than H(2)O(2). It was determined whether acrolein can serve as a biochemical marker for stroke (brain infarction) and chronic renal failure. Since acrolein rapidly reacts with lysine residues in protein, protein-conjugated acrolein (PC-Acro) was measured. PC-Acro was increased at the locus of brain infarction and in plasma in a mouse model of stroke involving photochemically induced thrombosis. An increase in PC-Acro in plasma was found to be a good biochemical marker in patients with stroke or with chronic renal failure. Using a receiver operating characteristic curve, the combined measurement of PC-Acro, IL-6 and CRP together with age indicated silent brain infarction (SBI) with 89% sensitivity and 91% specificity. The procedures to measure PC-Acro and polyamine oxidases [spermine oxidase (SMO) and acetylpolyamine oxidase (ACPAD)], and its application as markers in stroke and chronic renal failure are described in this chapter.