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一种新型基于心钠肽的治疗药物在实验性血管紧张素 II 介导的急性高血压中的应用。

A novel atrial natriuretic peptide based therapeutic in experimental angiotensin II mediated acute hypertension.

机构信息

Cardiorenal Research Laboratory, Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55905, USA.

出版信息

Hypertension. 2010 Dec;56(6):1152-9. doi: 10.1161/HYPERTENSIONAHA.110.159210. Epub 2010 Oct 25.

Abstract

M-atrial natriuretic peptide (ANP; M-ANP) is a novel next generation 40 amino acid peptide based on ANP, which is highly resistant to enzymatic degradation and has greater and more sustained beneficial actions compared with ANP. The current study was designed to advance our understanding of the therapeutic potential of M-ANP in a canine model of acute angiotensin II-induced hypertension with elevated cardiac filling pressures and aldosterone activation. We compare M-ANP with vehicle and equimolar human B-type natriuretic peptide, which possesses the most potent in vivo actions of the native natriuretic peptides. M-ANP significantly lowered mean arterial pressure and systemic vascular resistance. Importantly, despite a reduction in blood pressure, renal function was enhanced with significant increases in renal blood flow, glomerular filtration rate, diuresis, and natriuresis after M-ANP infusion. Although angiotensin II induced an acute increase in pulmonary capillary wedge pressure, M-ANP significantly lowered pulmonary capillary wedge pressure, pulmonary artery pressure, and right atrial pressure. Further, M-ANP significantly suppressed angiotensin II-induced activation of aldosterone. These cardiovascular and renal enhancing actions of M-ANP were accompanied by significant increases in plasma and urinary cGMP, the second messenger molecule of the natriuretic peptide system. When compared with human B-type natriuretic peptide, M-ANP had comparable cardiovascular actions but resulted in a greater natriuretic effect. These results suggest that M-ANP, which is more potent than ANP in normal canines, has potent blood pressure lowering and renal enhancing properties and may, therefore, serve as an ANP based therapeutic for acute hypertension.

摘要

M 型心钠肽(ANP;M-ANP)是一种新型的 40 个氨基酸肽,基于 ANP,对酶降解具有高度抗性,与 ANP 相比具有更大和更持续的有益作用。本研究旨在深入了解 M-ANP 在犬急性血管紧张素 II 诱导高血压模型中的治疗潜力,该模型伴有升高的心脏充盈压和醛固酮激活。我们将 M-ANP 与载体和等摩尔的人 B 型利钠肽进行比较,后者具有天然利钠肽中最强的体内作用。M-ANP 显著降低平均动脉压和全身血管阻力。重要的是,尽管血压降低,但肾血流量、肾小球滤过率、利尿和排钠量均显著增加,提示肾功能增强。尽管血管紧张素 II 引起肺毛细血管楔压急性升高,但 M-ANP 可显著降低肺毛细血管楔压、肺动脉压和右心房压。此外,M-ANP 可显著抑制血管紧张素 II 诱导的醛固酮激活。M-ANP 的这些心血管和肾脏增强作用伴随着血浆和尿液中环磷酸鸟苷(cGMP)的显著增加,cGMP 是利钠肽系统的第二信使分子。与人 B 型利钠肽相比,M-ANP 具有相似的心血管作用,但具有更大的利钠作用。这些结果表明,M-ANP 在正常犬中比 ANP 更有效,具有强大的降压和增强肾脏作用,因此可能作为一种基于 ANP 的急性高血压治疗药物。

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