Metabolic actions of natriuretic peptides and therapeutic potential in the metabolic syndrome.
Natriuretic peptides (NPs) are a group of peptide-hormones mainly secreted from the heart, signaling via c-GMP coupled receptors. NP are well known for their renal and cardiovascular actions, reducing arterial blood pressure as well as sodium reabsorption. Novel physiological functions have been discovered in recent years, including activation of lipolysis, lipid oxidation, and mitochondrial respiration. Together, these responses promote white adipose tissue browning, increase muscular oxidative capacity, particularly during physical exercise, and protect against diet-induced obesity and insulin resistance. Exaggerated NP release is a common finding in congestive heart failure. In contrast, NP deficiency is observed in obesity and in type-2 diabetes, pointing to an involvement of NP in the pathophysiology of metabolic disease. Based upon these findings, the NP system holds the potential to be amenable to therapeutical intervention against pandemic diseases such as obesity, insulin resistance, and arterial hypertension. Various therapeutic approaches are currently under development. This paper reviews the current knowledge on the metabolic effects of the NP system and discusses potential therapeutic applications.
Department of Endocrinology, Diabetes and Nutrition, Center for Cardiovascular Research, Charité, University School of Medicine, Berlin, Germany.
Nina
N
Schlueter
Department of Endocrinology, Diabetes and Nutrition, Center for Cardiovascular Research, Charité, University School of Medicine, Berlin, Germany.
Anita
A
de Sterke
Department of Endocrinology, Diabetes and Nutrition, Center for Cardiovascular Research, Charité, University School of Medicine, Berlin, Germany.
Diana M
DM
Willmes
Department of Endocrinology, Diabetes and Nutrition, Center for Cardiovascular Research, Charité, University School of Medicine, Berlin, Germany.
Joachim
J
Spranger
Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany.
Jens
J
Jordan
Department of Endocrinology, Diabetes and Nutrition, Center for Cardiovascular Research, Charité, University School of Medicine, Berlin, Germany. Electronic address: andreas.birkenfeld@charite.de.
Andreas L
AL
Birkenfeld
D000818:Animals; D006152:Cyclic GMP / Q000378:metabolism; D015195:Drug Design; D015444:Exercise / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology; D007333:Insulin Resistance / Q000502:physiology; D024821:Metabolic Syndrome / Q000188:drug therapy* / Q000503:physiopathology; D045265:Natriuretic Peptides / Q000378:metabolism*; D009765:Obesity / Q000188:drug therapy / Q000503:physiopathology
D045265:Natriuretic Peptides; D006152:Cyclic GMP
ANP; BNP; Diabetes; Insulin resistance; Natriuretic peptides; Obesity