Nesiritide acetate

Description

B-type natriuretic peptide is the only cardiac natriuretic peptide common to all vertebrate species thus far examined. The plasma BNP level is used as a robust and reliable biomarker for the diagnosis and prognosis of heart failure. BNP was isolated in 1988 from porcine brain extracts and was thus named the brain natriuretic peptide. Soon thereafter, BNP was found to be expressed abundantly in the cardiac ventricle and scarcely in the brains of humans and rats. Currently, BNP has been recognized as a principal cardiac hormone and referred to as the B-type natriuretic peptide.

The Uses of Nesiritide acetate

hemostatic, antimicrobial

What are the applications of Application

BNP (1-32), human is a brain natriuretic peptide

Clinical Use

The severity of CHF assessed by the New York Heart Association (NYHA) functional classification is correlated positively with the elevation of plasma BNP and NT-proBNP levels. Therefore, these peptides are used for the diagnosis and management of patients with CHF. The use of a recombinant BNP, nesiritide, for treatment has been approved by the US Food and Drug Administration. It has beneficial effects in patients with acute, decompensated heart failure; however, it is reported to increase the risk of renal dysfunction and mortality. Further evaluation is required for the clinical use of nesiritide.

Structure and conformation

Human proBNP consists of 108 aa residues with bioactive mature BNP (47 aa residues) at the C-terminus. Like other natriuretic peptides (NPs), BNP has an intramolecular ring consisting of 17 aa residues and N- and C-terminal extensions of varying length. All vertebrate species (tetrapods and fish) except for chondrichthyes and cyclostomes possess BNP.2 Thus, the BNP gene (nppb) is considered to have occurred before the divergence of ray-finned fish and lobefinned fish. The sequence identity of mature BNP is quite variable in mammals (<50% identity between human and mouse BNP), whereas the identity is relatively high among nonmammalian vertebrates.

References

1. Ziskoven D, Forssmann WG, Holthausen U, Menz G, Addicks K, Rippegater G: Calcium Calmodulinantagonists Influences the release of Cardiodilatin/ANP from Atrial Cardiocytes. Handbook Endocrinology of the Heart, edited by Kaufmann W, Wambach G, 01/1989; Springer Verlag Berlin Heidelberg New York;2. Maisel A, Krishnaswamy P, Nowak R, McCord J, Hollander J, Duc P, Omland T, Storrow A, Abraham W, Wu A, Clopton P, Steg P, Westheim A, Knudsen C, Perez A, Kazanegra R, Herrmann H, McCullough P (2002). "Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure". N Engl J Med 347 (3): 161–7.3. O'Connor CM, Starling RC, Hernandez AF, et al. Effect of nesiritide in patients with acute decompensated heart failure. TheNew Englandjournal of medicine 2011;365:32-43.