Natriuretic peptides (NPs) are a family of polypeptides characterised by vasorelaxing activity and potent natriuretic effects. They were first identified in 1981 by the pivotal work of de Bold and colleagues. In the 25 years elapsed since the initial discovery, an impressive amount of research has been carried out to identify the structure of the active peptide and its receptors, to characterise the biological functions of these molecules and their involvement in the pathophysiology of diseases and, finally, to identify their direct contributory role in the pathogenesis of some cardiovascular disorders. NPs include different biologically active fragments: the atrial natriuretic peptide (ANP), the brain natriuretic peptide (BNP) and C-type natriuretic peptide (CNP). Extensive research has identified some interesting features of ANP and BNP. In particular, it has been demonstrated that the ANP plays a role in the regulation of salt and water balance, as well as that of blood pressure homeostasis. In addition, ANP is involved in the pathophysiology of hypertension and heart failure, and it exerts a cellular antiproliferative effect in the cardiovascular system. More recently, a direct contributory role of ANP in the development of hypertension and cerebrovascular disorders has been demonstrated. On the other hand, BNP has a key role in congestive heart failure, particularly because of its distinct enhancement in terms of myocardial expression and production. These observations have progressively led researchers to consider ANP as a potential determinant of cardiovascular diseases and qualified BNP as a sensitive and specific marker of cardiac dysfunction. In this article, the most recently pathophysiological properties of NPs are reviewed, with particular regard to the most intriguing new hypothesis on their pathological and clinical significance in different cardiovascular settings.
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine