Natriuretic Peptides by Aldo Clerico, Michele Emdin

By Aldo Clerico, Michele Emdin

Modern cardiovascular technological know-how has produced a innovative new inspiration: the center acts now not in simple terms as a pump, yet as a "gland", that's as a regulator of circulatory homeostasis and salt-water stability. This booklet combines the classical heamodynamic view with the hot neuro-hormonal paradigm, in all its power scientific implications. The e-book will curiosity physiologists and clinicians fascinated about the learn of the cardiovascular approach and care of center patients.

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The interesting finding that CNH production is stimulated by cytokines and growth factors suggests a link between cardiac endocrine activity and remodelling or inflammatory processes in myocardial and smooth muscle cells. A large number of studies have recently contributed to support this hypothesis [33-36, 50-53, 56-62]. More complex, and still in part unknown, is the effect of adrenergic stimulation on CNH production. The α1-adrenergic agonist phenylephrine enhances the expression of some transcription factors, such as Egr-1 and c-myc, regulating (usually increasing) the natriuretic peptide gene expression in cultured neonatal rat cardiomyocytes [12, 13, 18, 63-66].

Schematic structure of the natriuretic peptide receptors. Part A Domain structure of NPR-A and NPR-B. Part B Domain structure of NPR-C NPRs and Intracellular Second Messenger Signaling protein kinases type I (PKG I) and type II (PKG II) (Fig. 20). These proteins should be considered to be third messengers, which are differentially expressed in different cell types, ultimately modifying cellular functions [166, 167]. This specific action of CNH on target tissues depends essentially on two different mechanisms.

NH2- and COOH-terminus) show a high degree of variability among the natriuretic peptides, in terms of both length and amino acidic composition [1]. Fig. 1. Peptide chain of natriuretic peptide hormones ANP, BNP, CNP and DNP. The CNH share the same structure characterized by a cysteine bridge 22 Chapter 3 · The Cardiac Natriuretic Hormone System Fig. 2. Amino acid sequences of ANP, BNP, CNP and VNP in vertebrates. The identical amino acid residues in the same group are shaded. The intramolecular ring is connected with a line (modified from Takei [1]) Natriuretic hormone-like peptides seem to be present in the plant kingdom as well as in the animal kingdom [1-3]; thus indicating that this hormonal system, which has been shown to regulate solute transport in vertebrates, has evolved early in evolution [1-6].

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