LETTER TO THE EDITOR
C-type natriuretic peptide and vascular remodeling
Neil C. Davidson, MD, MRCPa and
Allan D. Struthers, MD, FRCP
a Department of Cardiology, Westmead Hospital, NSW 2010, Sydney, Australia
davidsonneil{at}bigpond.com
Morishige et al. (1) have reported local adenovirus-mediated transfer of C-type natriuretic peptide (CNP) to porcine coronary arteries, resulting in reduced stenosis of balloon-injured segments. This is an exciting development with obvious therapeutic potential. The investigators suggest several mechanisms by which CNP might regulate vascular remodeling, but they fail to mention the effects of CNP on the vascular renin-angiotensin system. Many studies have demonstrated that the natriuretic peptides have a tonic effect at various sites in the renin-angiotensin-aldosterone cascade (2), and we have demonstrated that CNP inhibits local conversion of angiotensin I to angiotensin II in the human forearm vasculature (3). These vascular effects of CNP in man in vivo are particularly relevant to the therapeutic potential of the technique described by Morishige, because of the known interspecies variability in the effects of the natriuretic peptides (2). The effects of angiotensin II on vascular remodeling are well-documented, and a reduction in local angiotensin II production is a potentially important mechanism for some of the observed effects of CNP.
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References
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1. Morishige K, Shimokawa H, Yamawaki T, et al. Local adenovirus-mediated transfer of C-type natriuretic peptide suppresses vascular remodeling in porcine coronary arteries in vivo. J Am Coll Cardiol. 2000;34:1040–1047
2. Wilkins MR, Redondo J, Brown LA. The natriuretic peptide family. Lancet. 1997;349:1307–1310[CrossRef][Medline]
3. Davidson NC, Barr CS, Struthers AD. C-type natriuretic peptide: an endogenous regulator of vascular angiotensin-converting enzyme activity. Circulation. 1996;93:1155–1159[Abstract/Free Full Text]
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