Brain natriuretic peptide - wikipedia Brain natriuretic peptide NPPB Available structures PDB Human UniProt search : PDBe RCSB List of PDB id codes 3N56, 1YK1 Identifiers Aliases NPPB, BNP, natriuretic peptide B External IDs OMIM : 600295 HomoloGene : 81698 GeneCards : NPPB Gene location ( Human ) Chr. Chromosome 1 ( human ) Band 1p36. 22 Start 11,857,464 bp End 11,858,931 bp RNA expression pattern More reference expression data Gene ontology Molecular function receptor binding protein binding diuretic hormone activity hormone activity peptide hormone receptor binding hormone receptor binding Cellular component extracellular region protein complex extracellular space nucleus cytoplasm perinuclear region of cytoplasm Biological process regulation of blood pressure negative regulation of angiogenesis cell surface receptor signaling pathway regulation of vascular permeability regulation of blood vessel size receptor guanylyl cyclase signaling pathway body fluid secretion regulation of blood vessel diameter protein folding antimicrobial humoral immune response mediated by antimicrobial peptide response to hypoxia negative regulation of systemic arterial blood pressure cGMP biosynthetic process inflammatory response heart development response to organic cyclic compound negative regulation of cell growth response to lipopolysaccharide positive regulation of urine volume positive regulation of renal sodium excretion response to drug response to peptide hormone negative regulation of smooth muscle cell proliferation response to calcium ion cell growth involved in cardiac muscle cell development cellular response to mechanical stimulus positive regulation of collecting lymphatic vessel constriction regulation of receptor activity Sources : Amigo / QuickGO Orthologs Species Human Mouse Entrez 4879 n / a Ensembl ENSG00000120937 n / a UniProt P16860 n / a RefSeq ( mRNA ) NM_002521 n / a RefSeq ( protein ) NP_002512 n / a Location ( UCSC ) Chr 1 : 11.86 -- 11.86 Mb n / a PubMed search n / a Wikidata View / Edit Human Brain natriuretic peptide ( BNP ) is a hormone secreted by cardiomyocytes in the ventricles in response to stretching caused by increased ventricular blood volume. BNP is named as such because it was originally identified in extracts of porcine brain. The 32 - amino acid polypeptide BNP is secreted attached to a 76 -- amino acid N - terminal fragment in the prohormone called NT - proBNP ( BNPT ), which is biologically inactive. Once released, BNP binds to and activates the atrial natriuretic factor receptor NPRA, and to a lesser extent NPRB, in a fashion similar to atrial natriuretic peptide ( ANP ) but with 10-fold lower affinity. The biological half - life of BNP, however, is twice as long as that of ANP, and that of NT - proBNP is even longer, making these peptides better targets than ANP for diagnostic blood testing. The physiologic actions of BNP are similar to those of ANP and include decrease in systemic vascular resistance and central venous pressure as well as an increase in natriuresis. The net effect of these peptides is a decrease in blood pressure due to the decrease in systemic vascular resistance and, thus, afterload. Additionally, the actions of both BNP and ANP result in a decrease in cardiac output due to an overall decrease in central venous pressure and preload as a result of the reduction in blood volume that follows natriuresis and diuresis. Contents 1 Biosynthesis 2 Physiologic effects 2.1 Renal 2.2 Adrenal 2.3 Vascular 2.4 Cardiac 2.5 Adipose tissue 3 Measurement 3.1 Interpretation of BNP 4 Therapeutic application 5 Synonyms 6 See also 7 References 8 Further reading 9 External links Biosynthesis BNP is synthesized as a 134 - amino acid preprohormone ( preproBNP ), encoded by the human gene NPPB. Removal of the 25 - residue N - terminal signal peptide generates the prohormone, proBNP, which is stored intracellularly as an O - linked glycoprotein ; proBNP is subsequently cleaved between arginine - 102 and serine - 103 by a specific convertase ( probably furin or corin ) into NT - proBNP and the biologically active 32 - amino acid polypeptide BNP - 32, which are secreted into the blood in equimolar amounts. Cleavage at other sites produces shorter BNP peptides with unknown biological activity. Processing of proBNP may be regulated by O - glycosylation of residues near the cleavage sites. Physiologic effects Since the actions of BNP are mediated via the ANP receptors, the physiologic effects of BNP are identical to those of ANP. Those will be reviewed here. Receptor - agonist binding causes a reduction in renal sodium reabsorption, which results in a decreased blood volume. Secondary effects may be an improvement in cardiac ejection fraction and reduction of systemic blood pressure. Lipolysis is also increased. Renal Dilates the afferent glomerular arteriole, constricts the efferent glomerular arteriole, and relaxes the mesangial cells. This increases pressure in the glomerular capillaries, thus increasing the glomerular filtration rate ( GFR ), resulting in greater filter load of sodium and water. Increases blood flow through the vasa recta, which will wash the solutes ( NaCl and urea ) out of the medullary interstitium. The lower osmolarity of the medullary interstitium leads to less reabsorption of tubular fluid and increased excretion. Decreases sodium reabsorption in the distal convoluted tubule ( interaction with NCC ) and cortical collecting duct of the nephron via guanosine 3 ', 5 ' - cyclic monophosphate ( cGMP ) dependent phosphorylation of ENaC. Its natriuretic effect is affected by dopamine and dopamine receptor D activity in vivo Inhibits renin secretion, thereby inhibiting the renin -- angiotensin -- aldosterone system. Adrenal Reduces aldosterone secretion by the zona glomerulosa of the adrenal cortex. Vascular Relaxes vascular smooth muscle in arterioles and venules by : Membrane Receptor - mediated elevation of vascular smooth muscle cGMP Inhibition of the effects of catecholamines Promotes uterine spiral artery remodeling, which is important for preventing pregnancy - induced hypertension. Cardiac Inhibits maladaptive cardiac hypertrophy Mice lacking cardiac NPRA develop increased cardiac mass and severe fibrosis and die suddenly Re-expression of NPRA rescues the phenotype. Adipose tissue Increases the release of free fatty acids from adipose tissue. Plasma concentrations of glycerol and nonesterified fatty acids are increased by i.v. infusion of ANP in humans. Activates adipocyte plasma membrane type A guanylyl cyclase receptors NPR - A Increases intracellular cGMP levels that induce the phosphorylation of a hormone - sensitive lipase and perilipin A via the activation of a cGMP - dependent protein kinase - I ( cGK - I ) Does not modulate cAMP production or PKA activity Measurement BNP and NT - proBNP are measured by immunoassay. Interpretation of BNP The main clinical utility of either BNP or NT - proBNP is that a normal level rules out acute heart failure in the emergency setting. An elevated BNP or NT - proBNP should never be used to `` rule in '' acute or chronic heart failure in the emergency setting due to lack of specificity. Either BNP or NT - proBNP can also be used for screening and prognosis of heart failure. BNP and NT - proBNP are also typically increased in patients with left ventricular dysfunction, with or without symptoms ( BNP accurately reflects current ventricular status, as its half - life is 20 minutes, as opposed to 1 -- 2 hours for NT - proBNP ). A cutoff in BNP concentration of 100 pg / ml has, for cardiac events, a sensitivity of approximately 100 %, a negative predictive value of approximately 100 %, a specificity of 90 %, and a positive predictive value of 78 % according to data from the United Kingdom. BNP is cleared by binding to natriuretic peptide receptors ( NPRs ) and neutral endopeptidase ( NEP ). Less than 5 % of BNP is cleared renally. NT - proBNP is the inactive molecule resulting from cleavage of the prohormone Pro-BNP and is reliant solely on the kidney for excretion. The achilles heel of the NT - proBNP molecule is the overlap in kidney disease in the heart failure patient population. Low BNP was found to be a predictor of survival to age 90 in men. Some laboratories report in units ng per Litre ( ng / L ), which is equivalent to pg / mL There is a diagnostic ' gray area ', often defined as between 100 and 500 pg / mL, for which the test is considered inconclusive, but, in general, levels above 500 pg / ml are considered to be positive. This so - called gray zone has been addressed in several studies, and using clinical history or other available simple tools can help make the diagnosis. BNP may be a reliable predictor of cardiovascular mortality in diabetics. BNP was found to have an important role in prognostication of heart surgery patients and in the emergency department. Bhalla et al. showed that combining BNP with other tools like ICG can improve early diagnosis of heart failure and advance prevention strategies. Utility of BNP has also been explored in various settings like preeclampsia, ICU and shock and ESRD. The effect or race and gender on value of BNP and its utility in that context has been studied extensively. NT - proBNP levels ( in pg / mL ) by NYHA functional class NYHA I NYHA II NYHA III NYHA IV 5th Percentile 33 103 126 148 Mean 1015 1666 3029 3465 95th Percentile 3410 6567 10,449 12,188 The BNP test is used as an aid in the diagnosis and assessment of severity of heart failure. A recent meta - analysis concerning effects of BNP testing on clinical outcomes of patients presenting to the emergency department with acute dyspnea revealed that BNP testing led to a decrease in admission rates and decrease in mean length of stay, although neither was statistically significant. Effects on all cause hospital mortality was inconclusive. The BNP test is also used for the risk stratification of patients with acute coronary syndromes. When interpreting an elevated BNP level, it is useful to remember that values may be elevated due to factors other than heart failure. Lower levels are often seen in obese patients. Higher levels are seen in those with renal disease, in the absence of heart failure. Therapeutic application Recombinant BNP, nesiritide, is used to treat decompensated heart failure. However, a recent clinical trial failed to show a benefit of nesiritide in patients with acute decompensated heart failure, and the authors could not recommend its use. Synonyms Other terms for BNP include B - type natriuretic peptide, ventricular natriuretic peptide and natriuretic peptide B ' ) See also Atrial natriuretic peptide C - type natriuretic peptide N - terminal prohormone of brain natriuretic peptide ( NT - proBNP ) References ^ Jump up to : GRCh38 : Ensembl release 89 : ENSG00000120937 - Ensembl, May 2017 Jump up ^ `` Human PubMed Reference : ''. Jump up ^ http://cvpharmacology.com/diuretic/natriuretics Jump up ^ Schellenberger U, O'Rear J, Guzzetta A, Jue RA, Protter AA, Pollitt NS ( July 2006 ). `` The precursor to B - type natriuretic peptide is an O - linked glycoprotein ''. Arch. Biochem. Biophys. 451 ( 2 ) : 160 -- 6. 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PMID 15732251. LaPointe MC ( 2005 ). `` Molecular regulation of the brain natriuretic peptide gene ''. Peptides. 26 ( 6 ) : 944 -- 56. PMID 15911064. doi : 10.1016 / j. peptides. 2004.08. 028. Hoffmann U, Borggrefe M, Brueckmann M ( 2006 ). `` New horizons : NT - proBNP for risk stratification of patients with shock in the intensive care unit ''. Critical care ( London, England ). 10 ( 2 ) : 134. PMC 1550883. PMID 16594987. doi : 10.1186 / cc4883. Suga S, Nakao K, Hosoda K, et al. ( 1992 ). `` Receptor selectivity of natriuretic peptide family, atrial natriuretic peptide, brain natriuretic peptide, and C - type natriuretic peptide ''. Endocrinology. 130 ( 1 ) : 229 -- 39. PMID 1309330. doi : 10.1210 / en. 130.1. 229. Kambayashi Y, Nakao K, Mukoyama M, et al. ( 1990 ). `` Isolation and sequence determination of human brain natriuretic peptide in human atrium ''. FEBS Lett. 259 ( 2 ) : 341 -- 5. PMID 2136732. doi : 10.1016 / 0014 - 5793 ( 90 ) 80043 - I. Hino J, Tateyama H, Minamino N, et al. ( 1990 ). `` Isolation and identification of human brain natriuretic peptides in cardiac atrium ''. Biochem. Biophys. Res. Commun. 167 ( 2 ) : 693 -- 700. PMID 2138890. doi : 10.1016 / 0006 - 291X ( 90 ) 92081 - A. Sudoh T, Maekawa K, Kojima M, et al. ( 1989 ). `` Cloning and sequence analysis of cDNA encoding a precursor for human brain natriuretic peptide ''. Biochem. Biophys. Res. Commun. 159 ( 3 ) : 1427 -- 34. PMID 2522777. doi : 10.1016 / 0006 - 291X ( 89 ) 92269 - 9. Seilhamer JJ, Arfsten A, Miller JA, et al. ( 1990 ). `` Human and canine gene homologs of porcine brain natriuretic peptide ''. Biochem. Biophys. Res. Commun. 165 ( 2 ) : 650 -- 8. PMID 2597152. doi : 10.1016 / S0006 - 291X ( 89 ) 80015 - 4. Arden KC, Viars CS, Weiss S, et al. ( 1995 ). `` Localization of the human B - type natriuretic peptide precursor ( NPPB ) gene to chromosome 1p36 ''. Genomics. 26 ( 2 ) : 385 -- 9. PMID 7601467. doi : 10.1016 / 0888 - 7543 ( 95 ) 80225 - B. Weir ML, Pang SC, Flynn TG ( 1993 ). `` Characterization of binding sites in rat for A, B and C - type natriuretic peptides ''. Regul. Pept. 47 ( 3 ) : 291 -- 305. PMID 7901875. doi : 10.1016 / 0167 - 0115 ( 93 ) 90396 - P. Totsune K, Takahashi K, Satoh F, et al. ( 1996 ). `` Urinary immunoreactive brain natriuretic peptide in patients with renal disease ''. Regul. Pept. 63 ( 2 -- 3 ) : 141 -- 7. PMID 8837222. doi : 10.1016 / 0167 - 0115 ( 96 ) 00035 - 3. Totsune K, Takahashi K, Murakami O, et al. ( 1996 ). `` Immunoreactive brain natriuretic peptide in human adrenal glands and adrenal tumors ''. Eur. J. Endocrinol. 135 ( 3 ) : 352 -- 6. PMID 8890728. doi : 10.1530 / eje. 0.1350352. Matsuo K, Nishikimi T, Yutani C, et al. ( 1999 ). `` Diagnostic value of plasma levels of brain natriuretic peptide in arrhythmogenic right ventricular dysplasia ''. Circulation. 98 ( 22 ) : 2433 -- 40. PMID 9832489. doi : 10.1161 / 01. CIR. 98.22. 2433. Wiese S, Breyer T, Dragu A, et al. ( 2001 ). `` Gene expression of brain natriuretic peptide in isolated atrial and ventricular human myocardium : influence of angiotensin II and diastolic fiber length ''. Circulation. 102 ( 25 ) : 3074 -- 9. PMID 11120697. doi : 10.1161 / 01. CIR. 102.25. 3074. Shimizu H, Masuta K, Aono K, et al. ( 2002 ). `` Molecular forms of human brain natriuretic peptide in plasma ''. Clin. Chim. Acta. 316 ( 1 -- 2 ) : 129 -- 35. PMID 11750283. doi : 10.1016 / S0009 - 8981 ( 01 ) 00745 - 8. Ogawa K, Oida A, Sugimura H, et al. ( 2002 ). `` Clinical significance of blood brain natriuretic peptide level measurement in the detection of heart disease in untreated outpatients : comparison of electrocardiography, chest radiography and echocardiography ''. Circ. J. 66 ( 2 ) : 122 -- 6. PMID 11999635. doi : 10.1253 / circj. 66.122. Asakawa H, Fukui T, Tokunaga K, Kawakami F ( 2002 ). `` Plasma brain natriuretic peptide levels in normotensive Type 2 diabetic patients without cardiac disease and macroalbuminuria ''. J. Diabetes Complicat. 16 ( 3 ) : 209 -- 13. PMID 12015190. doi : 10.1016 / S1056 - 8727 ( 01 ) 00173 - 8. Bordenave L, Georges A, Bareille R, et al. ( 2003 ). `` Human bone marrow endothelial cells : a new identified source of B - type natriuretic peptide ''. Peptides. 23 ( 5 ) : 935 -- 40. PMID 12084525. doi : 10.1016 / S0196 - 9781 ( 02 ) 00004 - 9. External links Brain Natriuretic Peptide at the US National Library of Medicine Medical Subject Headings ( MeSH ) BNP and NT - proBNP at Lab Tests Online Human NPPB genome location and NPPB gene details page in the UCSC Genome Browser. Hormones Endocrine glands Hypothalamic - pituitary Hypothalamus GnRH TRH Dopamine CRH GHRH Somatostatin ( GHIH ) MCH Posterior pituitary Oxytocin Vasopressin Anterior pituitary FSH LH TSH Prolactin POMC CLIP ACTH MSH Endorphins Lipotropin GH Adrenal axis Adrenal cortex aldosterone cortisol cortisone DHEA DHEA - S androstenedione Adrenal medulla epinephrine norepinephrine Thyroid Thyroid hormone Calcitonin Thyroid axis Parathyroid PTH Gonadal axis Testis testosterone AMH inhibin Ovary estradiol progesterone activin and inhibin relaxin ( pregnancy ) Placenta hCG HPL estrogen progesterone Pancreas glucagon insulin amylin somatostatin pancreatic polypeptide Pineal gland melatonin N, N - dimethyltryptamine 5 - methoxy - N, N - dimethyltryptamine Other Thymus Thymosins Thymosin α1 Beta thymosins Thymopoietin Thymulin Digestive system Stomach gastrin ghrelin Duodenum CCK Incretins GIP GLP - 1 secretin motilin VIP Ileum enteroglucagon peptide YY Liver / other Insulin - like growth factor IGF - 1 IGF - 2 Adipose tissue leptin adiponectin resistin Skeleton Osteocalcin Kidney JGA ( renin ) peritubular cells EPO calcitriol prostaglandin Heart Natriuretic peptide ANP BNP Protein : nerve tissue protein Synuclein Alpha - synuclein Beta - synuclein Gamma - synuclein Other Agrin Chimerin Granin Chromogranin A FMR1 Gap - 43 protein GLUT3 Myelin Brain natriuretic peptide Nerve growth factor SCG5 Neurogranin Neuronal calcium sensor Neuropeptide Olfactory marker protein S100 protein Calgranulin Synapsin Synaptophysin Tubulin GPM6A Retrieved from `` https://en.wikipedia.org/w/index.php?title=Brain_natriuretic_peptide&oldid=804435396 '' Categories : Genes on human chromosome 1 Cardiology Hidden categories : All accuracy disputes Articles with disputed statements from April 2014 Talk Contents About Wikipedia Deutsch ދިވެހިބަސް Español Français Galego Italiano Nederlands 日本 語 Polski Português Русский Српски / srpski Srpskohrvatski / српскохрватски Suomi Svenska Українська Edit links This page was last edited on 9 October 2017, at 00 : 23. 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Question: bnp is secreted from the ventricular myocardium in response to
Answer: stretching caused by increased ventricular blood volume