Tan A C, Russel F G, Thien T, Benraad T J
Department of Experimental and Chemical Endocrinology, University Hospital of Nijmegen, The Netherlands.
Clin Pharmacokinet. 1993 Jan;24(1):28-45. doi: 10.2165/00003088-199324010-00003.
The atrial natriuretic peptide (ANP) is part of a new family of cardiac hormones regulating water and salt homeostasis. Besides acting as a blood pressure-lowering agent, it also exerts potent natriuretic and diuretic effects. ANP can be considered an endogenous antagonist of the reninangiotensin-aldosterone system and the antidiuretic hormone. One of the roles of ANP is to protect the body against fluid overload: it decreases intravascular fluid volume, which in turn diminishes cardiac secretion of ANP. The pharmacokinetic parameters of ANP reported in the literature vary widely. In general, ANP rapidly disappears from plasma with a high total body clearance. This is in agreement with the short-lived effects of the hormone. The actions of ANP have led to efforts to use this peptide hormone in the treatment of various cardiovascular disorders such as hypertension and congestive heart failure. Intravenous ANP administration indeed resulted in beneficial effects in these disorders. However, the peptide nature of ANP and its rapid elimination from the circulation limit its suitability as a drug. More promising is the development of long-acting ANP analogues and inhibitors of ANP degradation. Proper understanding of ANP pharmacokinetics is essential for the clinical use of these pharmacological agents.
心房利钠肽（ANP）是调节水盐平衡的新的心脏激素家族的一部分。除了作为一种降血压药物外，它还具有强大的利钠和利尿作用。ANP可被视为肾素-血管紧张素-醛固酮系统和抗利尿激素的内源性拮抗剂。ANP的作用之一是保护身体免受液体过载：它减少血管内液体量，进而减少心脏分泌ANP。文献中报道的ANP的药代动力学参数差异很大。一般来说，ANP在血浆中迅速消失，全身清除率很高。这与该激素的短期作用一致。ANP的作用促使人们努力将这种肽类激素用于治疗各种心血管疾病，如高血压和充血性心力衰竭。静脉注射ANP确实在这些疾病中产生了有益的效果。然而，ANP的肽性质及其从循环中迅速消除限制了它作为药物的适用性。更有前景的是长效ANP类似物和ANP降解抑制剂的开发。正确理解ANP的药代动力学对于这些药物的临床应用至关重要。
