C-type natriuretic peptide (CNP) signal peptide fragments are present in the human circulation.
BACKGROUND
Signal peptides may be novel biomarkers in cardiovascular diseases.


METHODS
We developed a novel immunoassay to the signal peptide of preproCNP (CNPsp) and used this to document circulating venous concentrations of CNPsp in normal healthy volunteers (n=109), regional plasma CNPsp concentrations in patients undergoing clinically indicated catheterisation (n=24) and temporal CNPsp concentrations in patients with ST-elevation myocardial infarction (STEMI) <4h after symptom onset (n=8). The structure/sequence of circulating CNPsp was confirmed by tandem mass spectrometry (MS/MS).


RESULTS
In normal human plasma, CNPsp was detectable at levels higher than NT-proCNP (74±17 vs. 20 ± 5.5 pmol/L). There was no correlation between NTproCNP and CNPsp, but plasma concentrations of sibling signal peptides - CNPsp and BNPsp - were strongly correlated (r=0.532, P<0.001). In patients undergoing catheterisation, there were significant arterio-venous step-ups in CNPsp concentrations across the heart (P<0.01) and kidney (P<0.01). Arterial concentrations of CNPsp significantly correlated with heart rate (r=0.446, P<0.05). In STEMI patients, plasma concentrations of CNPsp showed a biphasic elevation pattern between 6 and 12h after symptom onset, with 12h values significantly elevated (∼ 3-fold) compared with levels at presentation (P<0.05). MS/MS verified circulating CNPsp to be preproCNP(14-23) and preproCNP(16-23) peptides.


CONCLUSIONS
This is the first report of a circulating preproCNP derived signal peptide. Given the clear cardiac and renal secretion profiles of CNPsp and its response in STEMI patients, further studies on potential biological functions and biomarker applications of CNPsp in cardiovascular disease are warranted.
Christchurch Heart Institute, University of Otago, Christchurch, New Zealand. Electronic address: chris.pemberton@otago.ac.nz.
Chris J
CJ
Pemberton
Christchurch Heart Institute, University of Otago, Christchurch, New Zealand.
Maithri
M
Siriwardena
Centre for Protein Research, Department of Biochemistry, University of Otago, New Zealand.
Torsten
T
Kleffmann
Christchurch Heart Institute, University of Otago, Christchurch, New Zealand; National University Heart Centre, Singapore.
A Mark
AM
Richards
D015415:Biomarkers / Q000097:blood; D001775:Blood Circulation; D006801:Humans; D007118:Immunoassay; D013058:Mass Spectrometry; D009203:Myocardial Infarction / Q000097:blood*; D020098:Natriuretic Peptide, C-Type / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D021382:Protein Sorting Signals
D015415:Biomarkers; D010446:Peptide Fragments; D021382:Protein Sorting Signals; D020098:Natriuretic Peptide, C-Type
Biomarkers; CNP; Mass spectrometry; Myocardial infarction; Signal peptide