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Molecular Implications of Natriuretic Peptides in the Protection from Hypertension and Target Organ Damage
Speranza Rubattu1,2, Maurizio Forte3, Simona Marchitti4
1Department of Clinical and Molecular Medicine, School of Medicine and Psychology, Sapienza University of Rome, 00189 Rome, Italy. rubattu.speranza@neuromed.it.
Insights
The natriuretic peptide (NP) system, including NPs and their receptors, plays a crucial role in regulating blood pressure and protecting against cardiovascular damage. Understanding these mechanisms offers insights into hypertension pathogenesis and treatment.
Area of Science:
- Cardiovascular Physiology
- Endocrinology
- Molecular Medicine
Background:
- Hypertension is a complex, multifactorial condition linked to cardiovascular damage.
- Neurohormonal system abnormalities contribute to hypertension and cardiovascular remodeling.
- The natriuretic peptide (NP) system offers protective mechanisms against hypertension and related conditions.
Purpose of the Study:
- To review the molecular mechanisms of the NP system's impact on blood pressure regulation.
- To summarize evidence on the NP system's role in hypertension development.
- To discuss the protective effects of NPs against hypertensive target organ damage.
Main Methods:
- Review of experimental studies in animal models.
- Analysis of molecular mechanisms underlying NP system function.
- Synthesis of evidence on NP system's role in human hypertension.
Main Results:
- The NP system, comprising NPs, receptors, and convertases, is vital for blood pressure homeostasis.
- Experimental studies highlight the NP system's critical role in hypertension development.
- NPs demonstrate protective effects against cardiovascular damage associated with hypertension.
Conclusions:
- The NP system is a key regulator of blood pressure and a target for managing hypertension.
- Translational research on the NP system provides valuable insights into hypertension pathogenesis.
- Understanding the NP system's protective role is crucial for preventing hypertensive target organ damage.
Abstract:
The pathogenesis of hypertension, as a multifactorial trait, is complex. High blood pressure levels, in turn, concur with the development of cardiovascular damage. Abnormalities of several neurohormonal mechanisms controlling blood pressure homeostasis and cardiovascular remodeling can contribute to these pathological conditions. The natriuretic peptide (NP) family (including ANP (atrial natriuretic peptide), BNP (brain natriuretic peptide), and CNP (C-type natriuretic peptide)), the NP receptors (NPRA, NPRB, and NPRC), and the related protease convertases (furin, corin, and PCSK6) constitute the NP system and represent relevant protective mechanisms toward the development of hypertension and associated conditions, such as atherosclerosis, stroke, myocardial infarction, heart failure, and renal injury. Initially, several experimental studies performed in different animal models demonstrated a key role of the NP system in the development of hypertension. Importantly, these studies provided relevant insights for a better comprehension of the pathogenesis of hypertension and related cardiovascular phenotypes in humans. Thus, investigation of the role of NPs in hypertension offers an excellent example in translational medicine. In this review article, we will summarize the most compelling evidence regarding the molecular mechanisms underlying the physiological and pathological impact of NPs on blood pressure regulation and on hypertension development. We will also discuss the protective effect of NPs toward the increased susceptibility to hypertensive target organ damage.
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