Role of C-type Natriuretic Peptide in Linear Growth

ABSTRACT

The natriuretic peptides are a family of three peptides, atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP) and C-type natriuretic peptide (CNP). CNP is produced in the growth plate and acts in a paracrine/autocrine manner and has been found to play an essential role in enchondral bone growth , as demonstrated in rodents and human. Biosynthetic processing of CNP releases a bioinactive amino-terminal propeptide of C-type natriuretic peptide (NTproCNP) and is produced in equimolar amounts with CNP. The level of NTproCNP in plasma reflects the rate of CNP biosynthesis and measured easily using commercial kit by enzyme-linked immunosorbent assay (ELISA) method. Knockout mice for CNP or its cognate receptor (NPR-B) are dwarfed. In human, homozygous loss of functional mutations in the NPR-B gene causes acromesomelic dysplasia, Maroteaux type (OMIM #602875). To clarify the role of CNP/NTproCNP in linear growth in human, some researchers measured plasma NTproCNP levels in healthy children and children with short stature due to various causes. CNP showed the heighest levels after 12 hr of life and with a progressive decline afterwards. It is proved that there is modest but significant correlation between NTproCNP level and IGF-I in healthy children and the timing of peaks in NTproCNP and IGF-I were identical in both sex. This paper will introduce recent advances of researches concerning about the role of CNP/NTproCNP in human growth in children with various conditions and suggest the future direction of this promising study field.