Natriuretic Peptides

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Introduction

Natriuretic peptide (NP) is a peptide that causes renal sodium excretion by the kidney. What’s more, it plays a very significant role in the regulation of extracellular fluid, electrolyte balance, and blood pressure. On one hand, it can affect the internal environment by their function such asdiuresis, natriuresis, vasodilation, inhibition of the sympathetic system and complex interaction with vasopressin and cytokines. On the other hand, the natriuretic peptide family is consists of an atrial natriuretic peptide, brain natriuretic peptide, C-type natriuretic peptide, Dendroaspis natriuretic peptide, and urodilatin. They play an important role in the diagnosis of some diseases, especially in cardiovascular diseases. Meanwhile, with the help of type-C receptor, natriuretic peptides can be cleared from the circulation through endopeptidases present on the surface of epithelial cells, smooth muscles, myocytes, renal epithelium, and fibroblasts.

Mechanism of action

The natriuretic peptide mainly works by interaction with high-affinity receptors on the surface of target cells. In addition, natriuretic peptides have three main receptors such as, A, B, and C, in among them, receptor C is involved in the peptide clearance through binding to natriuretic peptides and internalization and enzyme degradation, after which the C receptor returns to the cell surface. Natriuretic peptide receptors A and B are similar in structure, for example, they have approximately 44% homology in the extracellular domain of ligand-binding. The A receptor binds both brain natriuretic peptides and atrial, in particular, atrial natriuretic peptide. At the same time, the A receptor is the most abundant type in large blood vessels, while there are also some B receptors. Because of the B receptors predominate in the brain. Both receptors are present in the kidney and adrenal glands. Meanwhile, C-type natriuretic peptide is the natural ligand for the B receptor.

Application of Natriuretic Peptides

Natriuretic peptides play a very important role in adjusting electrolyte balance, extracellular fluid, and blood pressure. They can affect the internal milieu by their actions of diuresis, natriuresis, vasodilation et al. In addition, natriuretic peptides have direct vasodilating effects and indirect prohypotensive activity through inhibiting the vasoconstriction of norepinephrine, angiotensin II and vasopressin. Furthermore, they weaken the central pressor effects of angiotensin II and vasopressin and central stimulation of the sympathetic system.

References

1. Das, B. B., Raj, S., & Solinger, R. (2009). Natriuretic peptides in cardiovascular diseases of fetus, infants and children. Cardiovascular & Hematological Agents in Medicinal Chemistry (Formerly Current Medicinal Chemistry-Cardiovascular & Hematological Agents), 7(1), 43-51.
2. Levin, E. R., Gardner, D. G., & Samson, W. K. (1998). Natriuretic peptides. New England Journal of Medicine, 339(5), 321-328.
3. Charpentier, J., Luyt, C. E., Fulla, Y., Vinsonneau, C., Cariou, A., Grabar, S., ... & Chiche, J. D. (2004). Brain natriuretic peptide: a marker of myocardial dysfunction and prognosis during severe sepsis. Critical care medicine, 32(3), 660-665.