BNP.pptx

The cardiac hormone known as brain natriuretic peptide (BNP), which is generated by ventricular myocytes, is crucial for controlling blood pressure and fluid volume.
While serum BNP levels rise with age in healthy individuals, more research is necessary to fully understand this response and potential sex differences in the setting of drug-induced cardiac damage.

1. University of Chakwal, Pakistan

2. Topic: Brain Natriuretic Peptide (BNP) Department of Zoology Presented by: Mehreen Afzal Roll no# UOC-BSZOL-F2020/ 031 BS Zoology Session: 2020-2024 Subject: Endocrinology Instructor Name: Dr. Syeda Nadia Ahmad

3. Brain Natriuretic Peptide

4. Introduction The cardiac hormone known as brain natriuretic peptide (BNP), which is generated by ventricular myocytes, is crucial for controlling blood pressure and fluid volume. While serum BNP levels rise with age in healthy individuals, more research is necessary to fully understand this response and potential sex differences in the setting of drug-induced cardiac damage(Waziri et al., 2023).

5. Discovery and structure of BNP In 1988, extracted brain natriuretic peptide (BNP) from pig brain natriuretic peptide ( pBNP ), which were initially termed after the porcine brain from which the protein was produced . It consists of 26 amino acid chains . Pig brain and heart have been shown to contain a bigger precursor form, 12 kDa , and another form, BNP1-32, which has six extra residues at the N-terminus . It quickly became evident that the heart, not the brain, was the primary source of this natriuretic peptide ( Maalouf & Bailey, 2016) .

6. BNP vs proBNP By attaching to the natriuretic peptide receptor type C (NPR-C) and being proteolyzed by neutral endopeptidases , BNP is removed from plasma. Conversely, NT- proBNP is primarily eliminated through renal excretion. Recent research indicates that there may be additional significant NT- proBNP clearance processes, nevertheless. Although both molecules are produced in equimolar amounts, NT- proBNP has a half-life of 120 minutes compared to 20 minutes for BNP. This difference in half-lives accounts for the roughly six-fold increase in NT- proBNP serum concentrations above BNP readings(Weber, 2005) .

7. Functions BNP has main functions: Cardiac function Vasodilation Fluid balance Diagnostic and monitoring Regulate blood pressure Figure 1.1: Shortness of breath https://images.app.goo.gl/ehFyFQEri56GG2zEA

8. Causes of high BNP levels: Cardiac causes Pulmonary embolism Heart failure Acute coronary syndrome Myocarditis Hypertrophic or restrictive cardiomyopathy Valvular heart disease Congenital heart disease Atrial and ventricular tachyarrhythmia Cardioversion, ICD shock Pulmonary hypertension Non cardiac causes Advance age Ischaemic stroke Renal dysfunction Liver dysfunction Paraneoplastic syndrome Chronic pulmonary obstructive disease Anaemia Severe burns

9. Up regulation of BNP The abnormal range of BNP when over from 100pg/ml in adults. Kidney failure Pulmonary embolism Pulmonary hypertension Sever infection (sepsis) Figure 1.2:Pulmonary embolism https://images.app.goo.gl/qoHWETmrvRGXMQVF8

10. Down regulation of BNP Normal levels of BNP is 125pg/ml in the age of 75 years 450pg/ml in over age of 75 900pg/ml is the sign of heart failure 100 pg /ml is normal in adult Figure 1.3:BNP Test https://images.app.goo.gl/Zs89KM3r9muaQo3B8

11. Symptoms of high BNP level Shortness of breath Sweating Fatigue Cough Rapid or irregular heartbeat Chest discomfort or pain Figure 1.4:Symptoms of High BNP https://images.app.goo.gl/priSaywHsnivkp5i9

12. Treatment Medications enhance heart health and lessen fluid accumulation, such as beta-blockers, diuretics, ACE inhibitors, and angiotensin receptor blockers. Dietary adjustments to lower salt consumption and fluid retention. Giving up drinking and quitting smoking. Figure 1.5:Beta blocker https://images.app.goo.gl/w1cNq6NqQ3SZefVF9

13. BNP receptor agonists and potential applications Nesiritide : A recombinant version of human BNP is called nesiritide . It is used to treat acute decompensated heart failure by predominantly activating NPA-B receptors. Sacubitril/Valsartan: The brand name Entresto refers to a combination medication used to treat heart failur . The sacubitril prevent the breakdown of natriuretic peptides such as BNP by inhibiting the enzyme neprilysin Figure 1.6 Sacubitril +valsartan https://images.app.goo.gl/494hWJCSH7Q3FnGu9

14. The impact of covid 19 on BNP in heart patients: The relationship between cardiac biomarker known as brain natriuretic peptide (BNP) and covid 19 can be seen specifically in patients with heart failure. The BNP assess the hemodynamic stress on the heart wall and have the potential to seras biomarker for evaluating the severity of covid 19 infection in heart failure patients ( Rawaz D.  Tawfeeq et al., 2023).

15. BNP and perpartum cardiomyopathy: Peripartum cardiomyopathy (PPCM) is an uncommon form of heart failure that can arise during pregnancy or in the postpartum period. It is associated with the higher levels of BNP. Increases BNP levels can be used to diagnose and gauge the severity of heart failure in patients with PAD by indicating myocardial stress(American Heart Association). Figure 1.7:Peripartum Cardiomyopathy https://images.app.goo.gl/nS9G5Y224x93uW5YA

16. BNP levels in obese and non obese patients: BNP and BMI have an inverse relationship. Lean patients with CHF have mean BNP values that are three times greater than those of obese patients . When the gender distribution of obese and non-obesity individuals is examined, the non-obesity group is disproportionately composed of females( Mehra et al., 2004) . Figure 1.8:Obesity and Cardiac function https://images.app.goo.gl/paxD1r2WT9RkVPCP9

17. BNP and proBNP monitoring: Assays: Radio-labeled tracers were used in competitive immunoassay techniques to provide the first BNP assays. Multiple cardiac biomarkers can be simultaneously screened for with micromosaic immunoassays ( μ MIAs). Pro-BNP and BNP breakdown products are measured by various commercially available BNP assays( Maalouf & Bailey, 2016) .

18. Biosensors to monitor BNP Electrochemical Sensors Optical Sensors Immunosensors Amperometric BNP biosensor Fluorescence-based BNP biosensors Antibody-based BNP immunosensor Conductometric BNP biosensor Chemiluminometric BNP biosensors Aptamer -based BNP immunosensor Impedimetric BNP biosensor SPR-based BNP biosensors Field effect transitor based BNP biosensor ( Dahiya et al., 2021)

19. References Waziri, B. I., Wali , N. Y., & Salisu , A. I. (2023). Age and sex variations in serum brain natriuretic peptide level following doxorubicin‑induced myocardial injury in Wistar rats.  circulation ,  3 , 4. Tawfeeq , R. D., Alwan , M. H., Ismael, A. T., & Hamad, B. K. (2023). The impact of COVID-19 on BNP, NT- proBNP and ANP in heart failure.  Cellular and Molecular Biology ,  69 (9), 143-148. Mehra, M. R., Uber, P. A., Park, M. H., Scott, R. L., Ventura, H. O., Harris, B. C., & Frohlich , E. D. (2004). Obesity and suppressed B-type natriuretic peptide levels in heart failure.  Journal of the American College of Cardiology ,  43 (9), 1590-1595. Weber, M., & Hamm, C. (2006). Role of B-type natriuretic peptide (BNP) and NT- proBNP in clinical routine.  Heart ,  92 (6), 843-849. Maalouf, R., & Bailey, S. (2016). A review on B-type natriuretic peptide monitoring: assays and biosensors.  Heart failure reviews ,  21 , 567-578. Dahiya, T., Yadav, S., Yadav, N., Mann, A., Sharma, M., & Rana , J. S. (2021). Monitoring of BNP cardiac biomarker with major emphasis on biosensing methods: a review.  Sensors International ,  2 , 100103.