B-type natriuretic peptide as a marker of heart failure: new insights from biochemistry and clinical implications.
The mature, biologically active 32-amino acid long B-type natriuretic peptide (BNP(1-32)), is cleaved by corin from the BNP prohormone. Recent data demonstrated that BNP(1-32) might be an ideal substrate for the endogenous aminopeptidase, dipeptidyl-peptidase (DPP) IV. DPP IV removes the two amino-terminal amino acids (Ser and Pro) from BNP(1-32) to produce BNP(3-32), which has been detected in plasma of patients with heart failure. In a canine model, intravenous BNP(3-32) infusion resulted in less natriuresis, diuresis and vasodilation compared to intravenous infusion of BNP(1-32). The clinical relevance of these observations may be important for patients with high plasma BNP concentrations, which can be measured by commercially available immunoassays. Further studies are needed to explore whether DPP IV inhibitors increase the bioavailability of BNP(1-32), delay the progression of heart failure and increase the efficacy of exogenously administered BNP(1-32) in decompensated heart failure.
Vanderheyden
Marc
M
Department of Cardiology, Onze Lieve Vrouwe Ziekenhuis, Moorselbaan 164, B-9300, Aalst, Belgium. marc.vanderheyden@olvz-aalst.be
Vrints
Chris
C
Verstreken
Sofie
S
Bartunek
Jozef
J
Beunk
Jan
J
Goethals
Marc
M
D000818:Animals; D015415:Biomarkers / Q000097:blood / Q000737:chemistry; D018450:Disease Progression; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D045283:Natriuretic Agents / Q000097:blood / Q000737:chemistry / Q000494:pharmacology / Q000502:physiology; D020097:Natriuretic Peptide, Brain / Q000097:blood / Q000737:chemistry / Q000494:pharmacology / Q000502:physiology; D010446:Peptide Fragments / Q000097:blood / Q000737:chemistry / Q000494:pharmacology / Q000502:physiology
D015415:Biomarkers; D045283:Natriuretic Agents; D010446:Peptide Fragments; C524086:Pro-BNP1-108; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain