title: Distinct downregulation of C-type natriuretic peptide system in human aortic valve stenosis.
abstract: BACKGROUND
  Aortic valve calcification is an actively regulated process that displays hallmarks of atherosclerosis. Natriuretic peptides (A-, B-, and C-type natriuretic peptides [ANP, BNP, and CNP]) have been reported to have a role in the pathogenesis of vascular atherosclerosis, but their expression in aortic valves is not known. Here, we characterized and compared expression of natriuretic peptide system in aortic valves of patients with normal valves (n=4), aortic regurgitation (n=11), regurgitation and fibrosis (n=6), and aortic valve stenosis (n=21).
  
  
  RESULTS
  By reverse-transcription polymerase chain reaction, all 3 natriuretic peptides were found to be expressed in aortic valves. CNP mRNA levels were 92% lower (P<0.001) in stenotic valves, whereas no significant changes in the expression of ANP and BNP genes were found compared with valves obtained from patients with aortic regurgitation. CNP was localized by immunohistochemistry with specific CNP (32-53) antibody to valvular endothelial cells and myofibroblasts. Gene expression of furin, which proteolytically cleaves proCNP into active CNP, was 54% lower in aortic valve stenosis (P=0.04). Moreover, natriuretic peptide receptor-A and natriuretic peptide receptor-B mRNA levels were 78% and 76% lower, respectively, in stenotic valves. In contrast, gene expression of corin, a proANP- and proBNP-converting enzyme, and natriuretic peptide receptor-C did not differ between groups.
  
  
  CONCLUSIONS
  We show that natriuretic peptides, their processing enzymes, and their receptors are expressed in human aortic valves. Aortic valve stenosis is characterized by distinct downregulation of gene expression of CNP, its processing enzyme furin, and the target receptors natriuretic peptide receptor-B and natriuretic peptide receptor-A, which suggests that CNP acts as a paracrine regulator of the aortic valve calcification process.
authors: Department of Pharmacology and Toxicology, University of Oulu, PO Box 5000, 90014 Oulu, Finland.
authors: Tuomas O
authors: TO
authors: Peltonen
authors: Panu
authors: P
authors: Taskinen
authors: Ylermi
authors: Y
authors: Soini
authors: Jaana
authors: J
authors: Rysä
authors: Jarkko
authors: J
authors: Ronkainen
authors: Pasi
authors: P
authors: Ohtonen
authors: Jari
authors: J
authors: Satta
authors: Tatu
authors: T
authors: Juvonen
authors: Heikki
authors: H
authors: Ruskoaho
authors: Hanna
authors: H
authors: Leskinen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000378:metabolism* / Q000473:pathology; D015536:Down-Regulation / Q000502:physiology*; D005260:Female; D005786:Gene Expression Regulation / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D020098:Natriuretic Peptide, C-Type / Q000037:antagonists & inhibitors* / Q000096:biosynthesis* / Q000235:genetics
chemical_list: D020098:Natriuretic Peptide, C-Type