| Intended use |
Atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP) an C-type natriuretic peptide (CNP) are members of a family of hormones secreted from the atrium, ventricle and vascular endothelial cells. Three receptors, type A (specific for ANP and BNP), type B (specific for CNP and ANP) and the clearance receptor, have been characterised. The mature form of BNP, secreted predominantly by the cardiac ventricle, is formed from a high molecular weight precursor, proBNP (1-108).
BNP is stored in the human cardiac tissue mainly as BNP-32, with a lesser amount of the precursor peptide, proBNP (1-108). The circulating plasma forms of BNP are BNP-32, a high molecular weight BNP form that has not been well identified, the BNP fragment and the amino-terminal portion of proBNP (1-76).
BNP elicits a spectrum of diuretic, natriuretic and hypotensive effects similar to those induced by ANP. Recent research suggests that natriuretic peptides are important protectors against fluid overload and high blood pressure. Control of fluid and electrolyte balance as well as circulatory homeostasis also involves other regulatory mechanism, including the renin-angiotensin system, vasopressin and the sympathetic nervous system. The discovery of natriuretic peptides has focused attention on an additional endocrine system that contributes to diuresis and vascular tone.
Clinical significance:
• Cardiac impairment
• myocardial infarction (left ventricular dysfunction)
• renal failure
• liver disease
• various forms of secondary hypertensions |
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