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Why is ANP called the ‘diuretic of the heart’? What is its secret?
In the medical field, the heart is regarded as one of the key organs of the human body, and its function and health directly affect the entire system. Among the many hormones of the heart, atrial natriuretic peptide (ANP) is known as the "diuretic of the heart" for its unique effects. However, why is this?
Discovery and structure of ANP
ANP was first reported in 1981 by Adolfo José de Bold. At the time, researchers identified a substance in rat atria extract that promoted the excretion of sodium and water by the kidneys. As the research progressed, the substance was purified and named atrial uretic factor (ANF) or atrial uretic peptide (ANP). The structure of ANP is composed of 28 amino acids, and the middle part presents a 17-amino acid ring structure. This feature distinguishes it from other similar diuretic peptides, such as brain uretic peptide (BNP) and C-type uretic peptide (CNP). Come.
Physiological effects of ANP
The main function of ANP is to reduce the expanded extracellular fluid volume by promoting renal salt excretion. When the atria stretch due to increased blood volume, volume receptors in the cardiomyocytes release ANP, which triggers a series of reactions:
The release of ANP can reduce blood volume, thereby regulating the volume of extracellular fluid, improving cardiac ejection fraction, and lowering blood pressure.
Renal effects of ANP
ANP acts primarily in the kidneys, increasing the excretion of sodium and water. It achieves this effect in a number of ways:
- Inhibits ENaC sodium channels in renal tubular epithelial cells, reducing sodium reabsorption.
- It promotes the improvement of renal tubular filtration rate (GFR) and increases the permeability of renal tubules.
- Directly dilates the renal arterioles entering the renal tubules, opposing the constriction induced by norepinephrine.
Effects of ANP on the Heart
ANP not only acts in the kidneys, but also plays a protective role in the heart. It helps to:
- Inhibit cardiac hypertrophy and reduce the burden of heart failure.
- Reduces fibrosis and limits changes in heart tissue.
Clinical significance of ANP
ANP deficiency can lead to a series of cardiac pathologies, such as atrial fibrillation and cardiac hypertrophy. Animal experiments have confirmed that the hearts of ANP-deficient mice will significantly hypertrophy under volume overload conditions, which shows the core role of ANP in cardiac development and function.
ANP and its drug development
The medical community has different views on the scope of ANP's therapeutic potential in acute heart failure and kidney disease. Although ANP has demonstrated good clinical improvement in certain crisis situations, its long-term effects and reduction in mortality still need further study. Currently, some newly synthesized ANP-type drugs, such as ularitide, have been shown to be safe and effective in the treatment of acute heart failure.
ANP as a biomarker
ANP and its precursors such as mid-region pro-atrial natriuretic peptide (MRproANP) in the blood are regarded as biomarkers of cardiovascular diseases. The sensitivity of MRproANP in the diagnosis of acute heart failure is higher than 120 pmol/L, indicating the importance of ANP in clinical diagnosis.
ConclusionAs a "diuretic for the heart", ANP encompasses mysterious biological functions and clinical applications. As research on ANP continues, we will gain a deeper understanding of its role in heart health. So, can future research on ANP reveal more therapeutic potential for heart disease?
