Kourek C, Briasoulis A, Giamouzis G, Skoularigis J, Xanthopoulos A. Lyophilized recombinant human brain natriuretic peptide: A promising therapy in patients with chronic heart failure. World J Clin Cases 2023; 11(36): 8603-8605 [PMID: 38188212 DOI: 10.12998/wjcc.v11.i36.8603]
Corresponding Author of This Article
Andrew Xanthopoulos, FACC, MD, PhD, Senior Postdoctoral Fellow, Department of Cardiology, University Hospital of Larissa, Mezourlo, Larissa 41110, Greece. andrewvxanth@gmail.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Dec 26, 2023; 11(36): 8603-8605 Published online Dec 26, 2023. doi: 10.12998/wjcc.v11.i36.8603
Lyophilized recombinant human brain natriuretic peptide: A promising therapy in patients with chronic heart failure
Christos Kourek, Alexandros Briasoulis, Grigorios Giamouzis, John Skoularigis, Andrew Xanthopoulos
Christos Kourek, Medical School of Athens, National and Kapodistrian University of Athens, Athens 15772, Greece
Alexandros Briasoulis, Department of Clinical Therapeutics, Alexandra Hospital, Faculty of Medicine, National and Kapodistrian University of Athens, Athens 11528, Greece
Grigorios Giamouzis, John Skoularigis, Andrew Xanthopoulos, Department of Cardiology, University Hospital of Larissa, Larissa 41110, Greece
Author contributions: Kourek C conceived and designed the study, acquired the data, and analyzed and interpreted the data; Briasoulis A, Giamouzis G, Skoularigis J, and Xanthopoulos A drafted and made critical revisions to the manuscript; all authors have read and gave final approval of the version of the article to be published.
Conflict-of-interest statement: All the authors state that they have no potential or real conflicts of interest to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Andrew Xanthopoulos, FACC, MD, PhD, Senior Postdoctoral Fellow, Department of Cardiology, University Hospital of Larissa, Mezourlo, Larissa 41110, Greece. andrewvxanth@gmail.com
Received: September 13, 2023 Peer-review started: September 13, 2023 First decision: December 5, 2023 Revised: December 5, 2023 Accepted: December 12, 2023 Article in press: December 12, 2023 Published online: December 26, 2023
Abstract
Lyophilized recombinant brain natriuretic peptide (BNP) is an exogenous peptide synthesized by artificial recombination technology, with a similar structure and similar physiological effects with the endogenous natriuretic peptide secreted by the human body. It’s main mechanism of action is to increase cyclic guanosine monophosphate by binding with its corresponding receptor in the body, regulating, thus, the imbalance of the vascular system and cardiac hemodynamics, improving the heart’s pumping capacity, and inhibiting sympathetic excitability and myocardial remodeling. Moreover, it can promote mitochondrial metabolism and enhance the use of adenosine triphosphate in cardiomyocytes. In the present study, 102 chronic heart failure (HF) patients were randomly assigned to a control and an observation group consisting of 51 patients each. Patients of the control group were treated with standard HF therapy for 3 d including oral metoprolol tartrate tablets, spironolactone, and olmesartanate while patients of the observation group were administered the recombinant human BNP injection for the same time-period, plus the standard HF therapy. The recombinant human BNP group (observation group) demonstrated better physical, emotional, social, and economic scores, as well as cardiac and inflammatory biomarkers such as serum hypersensitive C-reactive protein, N-terminal pro BNP and troponin I levels, compared to the control group. Moreover, cardiac function was also improved, as left ventricular ejection fraction and stroke volume were significantly higher in the observation group than in the control group. Interestingly, adverse reactions were not different between the 2 groups. However, these results are not generalizable and the need of large multicenter randomized controlled trials examining the safety and efficacy of recombinant human BNP in HF patients is of major importance.
Core Tip: Lyophilized recombinant brain natriuretic peptide is an exogenous peptide synthesized by artificial recombination technology, with a similar structure and similar physiological effects with the endogenous natriuretic peptide secreted by the human body. A recent single center, randomized study examined its safety and efficacy in 102 chronic heart failure patients, showing promising results. Larger randomized controlled trials are urgently needed.
