Abstract. By using transgenic and knockout mice, we have elucidated that C-type natriuretic peptide (CNP) is a potent stimulator of endochondral bone growth. In humans, loss-of-function mutations in the gene coding for guanylyl cyclase-B (GC-B), the specific receptor for CNP, have been proved to be the cause of acromesomelic dysplasia, type Maroteaux, one form of human skeletal dysplasias. Following these results, we have started to translate the stimulatory effect of CNP on endochondral bone growth into the therapy for patients with skeletal dysplasias. We have shown that targeted overexpression of CNP in cartilage or systemic administration of CNP reverses the impaired skeletal growth of mice model of achondroplasia, the most common form of human skeletal dysplasias.
Key words: C-type natriuretic peptide (CNP), Guanylyl cyclase-B (GC-B), Skeletal dysplasia, Achondroplasia, Translational researchThe nATriureTic peptide family consists of three structurally related peptides, atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), and C-type natriuretic peptide (CNP) [1]. The biological actions of natriuretic peptides are mediated by activation of two subtypes of membranous guanylyl cyclase (GC), GC-A and GC-B, followed by intracellular accumulation of cyclic GMP (cGMP) [2]. The rank order of potency to induce cGMP production via GC-A is ANP ≥ BNP >> CNP, while that via GC-B is CNP > ANP ≥ BNP [3]. Therefore, ANP and BNP serve as endogenous ligands for GC-A, whereas CNP is specific for GC-B. A third natriuretic peptide receptor with no intracellular guanylyl cyclase domain, dubbed the clearance receptor (C-receptor), is thought to be engaged in the receptor-mediated degradation of natriuretic peptides [2]. The ANP, BNP/GC-A system plays a pivotal role in the regulation of cardiovascular homeostasis, as demonstrated by their augmentation in various pathophysiological states such as heart failure [4][5][6][7][8], myocardial infarction [9, 10], cardiac hypertrophy [11,12], and hypertension [13][14][15]. In fact, ANP and BNP are cardiac hormones secreted primarily by the atrium and ventricle of the heart, respectively [8,15], with strong diuretic, natriuretic, and vasodilatory activities [4, 5, 8]. ANP and BNP are used in the treatment of heart failure [16,17] and serve as sensitive biochemical markers for heart failure and cardiac hypertrophy [6][7][8]. CNP, the third member of natriuretic peptide family, was first purified from porcine brain [18]. While CNP is the primary natriuretic peptide in the human brain [19], it is also produced by vascular endothelial cells [20][21][22] and macrophages [23], and is thought to act as an autocrine/paracrine regulator and as a neuropeptide [19]. Furthermore, analysis of genetically engineered mice of the CNP/GC-B system revealed that CNP and GC-B play a pivotal role in the regulation of endochondral bone growth.i. The growth promoting effect of the cnP/Gc-B system on endochondral bone growth
I-1. Skeletal phenotypes of genetically engineered mice of the CNP/GC-B sys...