The cardiac hormone atrial natriuretic peptide (ANP) is critically involved in the maintenance of arterial blood pressure and intravascular volume homeostasis. Its cGMP-producing GC-A receptor is densely expressed in the microvascular endothelium of the lung and systemic circulation, but the functional relevance is controversial. Some studies reported that ANP stimulates endothelial cell permeability, whereas others described that the peptide attenuates endothelial barrier dysfunction provoked by inflammatory agents such as thrombin or histamine. Many studies in vitro addressed the effects of ANP on endothelial proliferation and migration. Again, both pro-and anti-angiogenic properties were described. To unravel the role of the endothelial actions of ANP in vivo, we inactivated the murine GC-A gene selectively in endothelial cells by homologous loxP/Cre-mediated recombination. Our studies in these mice indicate that ANP, via endothelial GC-A, increases endothelial albumin permeability in the microcirculation of the skin and skeletal muscle. This effect is critically involved in the endocrine hypovolaemic, hypotensive actions of the cardiac hormone. On the other hand the homologous GC-A-activating B-type NP (BNP), which is produced by cardiac myocytes and many other cell types in response to stressors such as hypoxia, possibly exerts more paracrine than endocrine actions. For instance, within the ischaemic skeletal muscle BNP released from activated satellite cells can improve the regeneration of neighbouring endothelia. This review will focus on recent advancements in our understanding of endothelial NP/GC-A signalling in the pulmonary versus systemic circulation. It will discuss possible mechanisms accounting for the discrepant observations made for the endothelial actions of this hormone-receptor system and distinguish between (patho)physiological and pharmacological actions. Lastly it will emphasize the potential therapeutical implications derived from the actions of NPs on endothelial permeability and regeneration.
AbbreviationsANP, atrial natriuretic peptide; BNP, B-type natriuretic peptide; cGKI, cGMP-dependent protein kinase; VASP, vasodilator-stimulated phosphoprotein
IntroductionThe heart secretes two natriuretic peptides (NPs), atrial (ANPs) and B-type NPs (BNPs) (de Bold et al., 1981;Brenner et al., 1990), which activate a common GC-A receptor expressed in a wide variety of tissues and cell types (reviewed by Kuhn, 2003). GC-A [also known as NP receptor A (NPR-A)] is a transmembrane receptor with an intracellular GC domain (Alexander et al., 2011). It synthesizes the second messenger cGMP upon binding of the ligands (ANP with~10-fold higher affinity than BNP) to its extracellular part (Figure 1) (Drewett and Garbers, 1994). ANP is secreted from atrial granules into the circulation in response to acute or chronic atrial stretch to physiologically act as antihypertensive and antihypervolaemic factor via GC-A in distant organs (de Bold et al., 2001). In contrast, cardiac BNP is constitutively expressed i...