Test, as appropriate. Variables were compared among three groups using one-way analysis of variance followed by Bonferroni’s multiple comparisonTable 4. Intra- and Inter-assay precision of the total BNP systems.Added BNP concentration pmol/LMeasured concentration pmol/L Mean Intra-assay (n = 5) 2.0 25 100 Inter-assay (n = 15) 2.0 25 100 doi:10.1371/journal.pone.0053233.t004 2.3 25 99 2.1 24 100 S.D. 0.2 2.1 7.1 0.2 1.7 1.CV 7.0 8.4 7.2 9.5 2.9 1.Bias 15.0 1.0 20.7 5.0 24.0 0.proBNP in Human PlasmaTable 5. Cross-reactivity between proBNP and BNP.Added peptide concentration, pmol/L proBNP 50 100 10 doi:10.1371/journal.pone.0053233.tAdded peptide concentration, pmol/L BNP 50 10Measured peptide concentration, pmol/L proBNP assay 58 113Measured peptide concentration, pmol/L total BNP assay 114 119test. Correlation coefficients were calculated using linear regression analysis. Values of P,0.05 were considered significant.Results Standard curve, recovery and precisionFigure 2 shows typical standard curves for the proBNP and total BNP assay systems. The lower detection limits were 0.04 pmol/L (proBNP) and 0.02 pmol/L (total BNP). At these levels the mean value (n = 8 each) of the chemiluminescence intensity (cps) was more than twice that at 0 pmol/L (P,0.05). The working range (coefficient of variation (CV),15 ) of both assays was 0.2?250 pmol/L in total BNP and 0.4?50 pmol/L in proBNP, respectively.Table 1 shows the recovery of standard proBNP and BNP, which was estimated from the levels of glycosylated proBNP or BNP added to clinically available plasma (GHRH (1-29) supplier endogenous total BNP = 0.3 pmol/L and proBNP = 0.2 pmol/L). In the proBNP assay system, using glycosylated proBNP as a standard, the recovery ranged from 90?01 . In the total BNP assay system, using BNP as the standard the recovery ranged from 85?7 . The effect of diluting plasma samples containing 100 pmol/L glycosylated proBNP or BNP is shown in Table 2. At every dilution level, the recovery rate was good. We also investigated 
the effects of dilution on plasma levels of total BNP and proBNP in three heart failure patients. As shown in Figure 2B, the calculated total BNP and proBNP values varied linearly with dilution (correlation coefficients = 0.998?.00).Figure 3. Gel filtration analysis of total BNP (A) and proBNP (B) in plasma from a heart failure patient. Fractions were assayed using the total BNP (A) and proBNP (B) systems. The elution points for glycosylated proBNP, proBNP and BNP are indicated by red arrows. Black and red lines respectively show gel filtration analyses of total BNP (A) and proBNP (B) in the same plasma sample order Clavulanic acid potassium salt before and after deglycosylation. doi:10.1371/journal.pone.0053233.gproBNP in Human PlasmaGel-filtration chromatography before and after deglycosylation procedureFigure 3-A shows two immunoreactive BNP peaks detected using the total BNP assay with HPLC fractions. The first peak appeared in fractions 52?5 and the second peak in fractions 72?75. With the same sample, one immunoreactive BNP peak was detected by the proBNP assay (Figure 3-B); the position of that peak was completely consistent with the proBNP peak obtained with the total BNP assay. When subjected to gel filtration HPLC, recombinant proBNP, glycosylated proBNP and BNP were eluted mainly in fractions 53, 56 and 74, respectively. Treating the same plasma sample with an enzyme cocktail catalyzing deglycosylation shifted the first peak to fraction 54?6, which is consistent with the proBNP peak. From t.Test, as appropriate. Variables were compared among three groups using one-way analysis of variance followed by Bonferroni’s multiple comparisonTable 4. Intra- and Inter-assay precision of the total BNP systems.Added BNP concentration pmol/LMeasured concentration pmol/L Mean Intra-assay (n = 5) 2.0 25 100 Inter-assay (n = 15) 2.0 25 100 doi:10.1371/journal.pone.0053233.t004 2.3 25 99 2.1 24 100 S.D. 0.2 2.1 7.1 0.2 1.7 1.CV 7.0 8.4 7.2 9.5 2.9 1.Bias 15.0 1.0 20.7 5.0 24.0 0.proBNP in Human PlasmaTable 5. Cross-reactivity between proBNP and BNP.Added peptide concentration, pmol/L proBNP 50 100 10 doi:10.1371/journal.pone.0053233.tAdded peptide concentration, pmol/L BNP 50 10Measured peptide concentration, pmol/L proBNP assay 58 113Measured peptide concentration, pmol/L total BNP assay 114 119test. Correlation coefficients were calculated using linear regression analysis. Values of P,0.05 were considered significant.Results Standard curve, recovery and precisionFigure 2 shows typical standard curves for the proBNP and total BNP assay systems. 
The lower detection limits were 0.04 pmol/L (proBNP) and 0.02 pmol/L (total BNP). At these levels the mean value (n = 8 each) of the chemiluminescence intensity (cps) was more than twice that at 0 pmol/L (P,0.05). The working range (coefficient of variation (CV),15 ) of both assays was 0.2?250 pmol/L in total BNP and 0.4?50 pmol/L in proBNP, respectively.Table 1 shows the recovery of standard proBNP and BNP, which was estimated from the levels of glycosylated proBNP or BNP added to clinically available plasma (endogenous total BNP = 0.3 pmol/L and proBNP = 0.2 pmol/L). In the proBNP assay system, using glycosylated proBNP as a standard, the recovery ranged from 90?01 . In the total BNP assay system, using BNP as the standard the recovery ranged from 85?7 . The effect of diluting plasma samples containing 100 pmol/L glycosylated proBNP or BNP is shown in Table 2. At every dilution level, the recovery rate was good. We also investigated the effects of dilution on plasma levels of total BNP and proBNP in three heart failure patients. As shown in Figure 2B, the calculated total BNP and proBNP values varied linearly with dilution (correlation coefficients = 0.998?.00).Figure 3. Gel filtration analysis of total BNP (A) and proBNP (B) in plasma from a heart failure patient. Fractions were assayed using the total BNP (A) and proBNP (B) systems. The elution points for glycosylated proBNP, proBNP and BNP are indicated by red arrows. Black and red lines respectively show gel filtration analyses of total BNP (A) and proBNP (B) in the same plasma sample before and after deglycosylation. doi:10.1371/journal.pone.0053233.gproBNP in Human PlasmaGel-filtration chromatography before and after deglycosylation procedureFigure 3-A shows two immunoreactive BNP peaks detected using the total BNP assay with HPLC fractions. The first peak appeared in fractions 52?5 and the second peak in fractions 72?75. With the same sample, one immunoreactive BNP peak was detected by the proBNP assay (Figure 3-B); the position of that peak was completely consistent with the proBNP peak obtained with the total BNP assay. When subjected to gel filtration HPLC, recombinant proBNP, glycosylated proBNP and BNP were eluted mainly in fractions 53, 56 and 74, respectively. Treating the same plasma sample with an enzyme cocktail catalyzing deglycosylation shifted the first peak to fraction 54?6, which is consistent with the proBNP peak. From t.