Editorial Is atrial natriuretic peptide really a hormone ?
نویسنده
چکیده
Since the 1950s when granules were first observed histologically within the atrial wall there has been intense interest in their function. Two early key papers were those of Marie et al' and de Bold,2 who showed that the granulation was related to the water/electrolyte balance, although a first time reader's starting point should be the meticulous histological investigation of Jamieson and Palade.3 On pages 302-16 of this issue of the British Heart Journal Genest gives an excellent historical account of this exciting research, much of which has been conducted at the Clinical Research Institute of Montreal. There has been remarkably rapid progress in biochemical knowledge about atrial natriuretic peptides and perhaps now is the time to pause and take stock of the evidence about their postulated physiological functions. Because in humans and in rats the atrial natriuretic factor is elaborated and localised in the granules of the atrial cardiocytes and is released in the blood, it is suggested that the atrial natriuretic factor is "a true circulatory hormone".4 But is there any evidence for the usual process of secretion from the atrial muscle cell? Certainly there is no evidence that the plasma concentrations attained during applied physiological stimuli (such as stretch of left atrial wall) can evoke acute responses. There is only evidence that large doses or large infusions that produce pharmacological concentrations of atrial natriuretic peptide have effects on the blood vessels (arteries, arterioles, veins), causing relaxation, particularly of precontracted muscle, and on the kidneys, causing natriuresis and diuresis. Little is yet known of the biosynthesis and processing of atrial natriuretic peptide in, and its release from, the cardiocytes. Interpretation of the observed changes in granulation in relation to changes in fluid balance1 2 is at present difficult in view of studies5 6
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