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Biochemistry, Therapeutics, and Biomarker Implications of Neprilysin in Cardiorenal Disease.

Abstract Neprilysin (NEP) is a membrane-bound neutral endopeptidase that degrades a variety of bioactive peptides. The substrates include natriuretic peptides (NPs), which are important regulating mediators for cardiovascular and renal biology. Inhibition of NEP activity and exogenous NP administration thus have emerged as potential therapeutic strategies for treating cardiorenal diseases. More recently, B-type natriuretic peptide (BNP) or N-terminal-proBNP (NT-proBNP), 3'-5' cyclic guanosine monophosphate (cGMP), and soluble NEP as biomarkers have also been investigated in heart failure (HF) trials and their predictive value are beginning to be recognized.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title clinical chemistry
Publication Year Start




PMID- 28062615
OWN - NLM
STAT- In-Data-Review
DA  - 20170107
LR  - 20170108
IS  - 1530-8561 (Electronic)
IS  - 0009-9147 (Linking)
VI  - 63
IP  - 1
DP  - 2017 Jan
TI  - Biochemistry, Therapeutics, and Biomarker Implications of Neprilysin in
      Cardiorenal Disease.
PG  - 108-115
LID - 10.1373/clinchem.2016.262907 [doi]
AB  - BACKGROUND: Neprilysin (NEP) is a membrane-bound neutral endopeptidase that
      degrades a variety of bioactive peptides. The substrates include natriuretic
      peptides (NPs), which are important regulating mediators for cardiovascular and
      renal biology. Inhibition of NEP activity and exogenous NP administration thus
      have emerged as potential therapeutic strategies for treating cardiorenal
      diseases. More recently, B-type natriuretic peptide (BNP) or N-terminal-proBNP
      (NT-proBNP), 3'-5' cyclic guanosine monophosphate (cGMP), and soluble NEP as
      biomarkers have also been investigated in heart failure (HF) trials and their
      predictive value are beginning to be recognized. CONTENT: The biological
      functions of NEP and NPs are discussed. Enhancing NPs through NEP inhibition
      combined with renin-angiotensin-aldosterone system (RAAS) antagonism has proved
      to be successful in HF treatment, although future surveillance studies will be
      required. Direct NP enhancement through peptide delivery may have fewer
      potentially hazardous effects compared to NEP inhibition. Strategies of combined 
      inhibition on NEP with other cardiorenal pathophysiological pathways are
      promising. Finally, monitoring BNP/NT-proBNP/cGMP concentrations during NEP
      inhibition treatment may provide supplemental benefits to conventional
      biomarkers, and the identification of soluble NEP as a novel biomarker for HF
      needs further investigation. SUMMARY: In this review, the biology of NEP is
      summarized, with a focus on NP regulation. The degradation of NPs by NEP provides
      the rationale for NEP inhibition as a strategy for cardiorenal disease treatment.
      We also describe the current therapeutic strategies of NEP inhibition and NP
      therapeutics in cardiorenal diseases. Moreover, the discovery of its circulating 
      form, soluble NEP, as a biomarker is also discussed.
CI  - (c) 2016 American Association for Clinical Chemistry.
FAU - Chen, Yang
AU  - Chen Y
AD  - Biochemistry and Molecular Biology Graduate Program, Mayo Graduate School,
      Rochester, MN; [email protected]
AD  - Cardiorenal Research Laboratory, Department of Cardiovascular Diseases, Mayo
      Clinic, Rochester MN.
FAU - Burnett, John C Jr
AU  - Burnett JC Jr
AD  - Cardiorenal Research Laboratory, Department of Cardiovascular Diseases, Mayo
      Clinic, Rochester MN.
LA  - eng
PT  - Review
PT  - Journal Article
DEP - 20161115
PL  - United States
TA  - Clin Chem
JT  - Clinical chemistry
JID - 9421549
EDAT- 2017/01/08 06:00
MHDA- 2017/01/08 06:00
CRDT- 2017/01/08 06:00
PHST- 2016/06/29 [received]
PHST- 2016/09/27 [accepted]
AID - clinchem.2016.262907 [pii]
AID - 10.1373/clinchem.2016.262907 [doi]
PST - ppublish
SO  - Clin Chem. 2017 Jan;63(1):108-115. doi: 10.1373/clinchem.2016.262907. Epub 2016
      Nov 15.

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