Renal Research Institute, New York, NY, USA.
Associazione Ipertensione Nefrologia Trapianto Renale Reggio Cal, Italy.
Nephrol Dial Transplant. 2021 Dec 28;37(Suppl 2):ii14-ii23. doi: 10.1093/ndt/gfab284.
Neuropeptide Y (NPY) is a 36-amino-acid peptide member of a family also including peptide YY and pancreatic polypeptide, which are all ligands to Gi/Go coupled receptors. NPY regulates several fundamental biologic functions including appetite/satiety, sex and reproduction, learning and memory, cardiovascular and renal function and immune functions. The mesenteric circulation is a major source of NPY in the blood in man and this peptide is considered a key regulator of gut-brain cross talk. A progressive increase in circulating NPY accompanies the progression of chronic kidney disease (CKD) toward kidney failure and NPY robustly predicts cardiovascular events in this population. Furthermore, NPY is suspected as a possible player in accelerated cognitive function decline and dementia in patients with CKD and in dialysis patients. In theory, interfering with the NPY system has relevant potential for the treatment of diverse diseases from cardiovascular and renal diseases to diseases of the central nervous system. Pharmaceutical formulations for effective drug delivery and cost, as well as the complexity of diseases potentially addressable by NPY/NPY antagonists, have been a problem until now. This in part explains the slow progress of knowledge about the NPY system in the clinical arena. There is now renewed research interest in the NPY system in psychopharmacology and in pharmacology in general and new studies and a new breed of clinical trials may eventually bring the expected benefits in human health with drugs interfering with this system.
神经肽 Y（NPY）是一种 36 个氨基酸的肽，属于一个家族的成员，该家族还包括肽 YY 和胰多肽，它们都是 Gi/Go 偶联受体的配体。NPY 调节包括食欲/饱腹感、性和生殖、学习和记忆、心血管和肾功能以及免疫功能在内的多种基本生物学功能。肠系膜循环是人体内血液中 NPY 的主要来源，这种肽被认为是肠道-大脑相互作用的关键调节剂。随着慢性肾脏病（CKD）向肾衰竭的进展，循环 NPY 逐渐增加，并且在该人群中 NPY 可强烈预测心血管事件。此外，NPY 被怀疑是 CKD 患者和透析患者认知功能加速下降和痴呆的可能参与者。从理论上讲，干扰 NPY 系统对治疗从心血管和肾脏疾病到中枢神经系统疾病的各种疾病具有相关的潜在作用。用于有效药物输送和成本的药物制剂，以及潜在可通过 NPY/NPY 拮抗剂治疗的疾病的复杂性，一直是一个问题。这在一定程度上解释了目前 NPY 系统在临床领域的知识进展缓慢的原因。现在，在精神药理学和一般药理学中，人们对 NPY 系统重新产生了研究兴趣，新的研究和新一类临床试验最终可能会通过干扰该系统的药物为人类健康带来预期的益处。
