Summary
The search for drugs interacting with the ANP system to give favourable therapeutic effects has concentrated on the release and the metabolism of ANP. Regarding the release of ANP direct effects have to be distinguished from indirect ones. Both drug induced increases and decreases of ANP plasma levels may be indirectly mediated: Increased ANP plasma levels are noted after sodium retaining antihypertensives such as reserpine and minoxidil. On the other hand, the pathological high ANP plasma levels of SHR are normalized in parallel to the amelioration of cardiac hypertrophy by the natriuretic calcium antagonist nitrendipine. The mechanism for β-blocker-induced increase in plasma ANP is not clear as yet.
Direct effects on ANP release can be demonstrated using in vitro assays of isolated atria. An increase of ANP has been reported for agents increasing the intracellular calcium concentration such as the calcium agonist BAY K 8644, the newly discovered endogenous vasoconstrictor endothelin or the protein kinase C activator TPA. These effects can be antagonized by calcium antagonists, but calcium antagonists have no effect on baseline ANP release, and a reduction in intracellular or extracellular calcium has also been reported to increase ANP release in vitro.
A direct stimulatory effect on ANP release of isolated rat atria was found with the endogenous opioid peptide dynorphin. In contrast, the increase in ANP plasma levels after high dose of morphine seems to be mediated by the central nervous system.
For natriuretic drugs antagonization of ANP by monoclonal antibodies is another way to detect mechanisms of action involving endogenous ANP. Although the effects of exogenous and endogenous ANP were effectively blocked by the antibody in vivo, no diminution of the natriuretic effects of calcium antagonists or clonidine in rats could be observed.
Research in the metabolism of ANP has led to the discovery that enkephalinase inhibitors prolong the half life of ANP and enhance the effects of ANP. The therapeutic relevance of this mechanism has to be evaluated.
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© 1989 Springer-Verlag Berlin Heidelberg
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Hirth, C., Stasch, JP., Neuser, D., Kazda, S. (1989). Pharmacological Modification of the ANP System. In: Kaufmann, W., Wambach, G. (eds) Endocrinology of the Heart. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-83858-3_15
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DOI: https://doi.org/10.1007/978-3-642-83858-3_15
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