SUMMARY At least 16 naturally occurring peptides either constrict or dilate blood vessels. Many of these peptides are present in nerve cells and nerve terminals supplying systemic and pulmonary blood vessels and the heart. Such neuropeptides are released locally as neurotransmitters, and can influence vascular tone, local and regional blood flow, arterial blood pressure, and cardiac function. There is evidence for the participation of at least some vasoactive peptides in the regulation of these functions and in the mediation or modulation of systemic shock and arterial hypertension. The investigation of vasoactive peptides in relation to cardiovascular function and dysfunction is at a promising threshold. There is a growing conviction that these peptides participate in the regulation of many organ functions. Neuroscientists, endocrinologists, and gastroenterologists have led other groups in recognizing the likely physiological and clinical significance of these peptides, most of which are found in the brain and gut.1 " 1 Since many biologically active peptides are capable of influencing vascular smooth muscle, and thus blood flow and blood pressure, peptides with these vasoactive properties are reviewed here. Emphasis is placed on the cardiovascular effects of the more recently identified peptides, with special reference to their possible roles in the regulation of blood pressure in normal and abnormal states. Bradykinin and angiotensins, which are extensively reviewed elsewhere, are only briefly mentioned here.
Biological Activity of PeptidesWhich Peptides are Vasoactive?Peptides with vasoactive properties are given in the accompanying list (see box), which is not meant to be complete. For some of these peptides (e.g., angiotensin II, bradykinin), vasoactivity is a dominant feature of their biological actions; for others (e.g., prolactin, parathyroid hormone), the pressor or vasodepressor activity has generally been overshadowed by other actions of the peptide.As will become apparent in the following para : graphs, the ability to induce either vasodilation or vasoconstriction is shared by a variety of apparently unrelated peptides. It is possible in some instances, however, t o ' recognize certain structural features among these peptides that correlate with their vasodilator or vasoconstrictor activity. Such features will be noted.
AngiotensinsAngiotensin II (table 1) is one of the most potent systemic vasopressors known. Its formation from angiotensin I through the action of angiotensin-converting enzyme, the localization and properties of this enzyme, and the physiology, pathophysiology, and pharmacology of the renin-angiotensin systems in the body are topics of recent comprehensive reviews.5 "" Bombesin A 14-residue peptide (table 1) isolated from the skin of the frog Bombina bombina, bombesin has spasmogenic activity on a variety of vascular and non-vascular smooth muscle structures.12 It induces vasoconstriction and systemic hypertension in most animal species, hypotension in monkeys, but neither in humans...