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1.
Surg Obes Relat Dis ; 18(4): 485-493, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-34998697

RESUMO

BACKGROUND: Obesity and diabetes are associated with an increased incidence of pancreatic cancer. Fatty acid binding protein 4 (FABP4), noted to be higher in patients with severe obesity, is linked to the development and progression of several cancers, and its level in the circulation decreases after bariatric surgery. OBJECTIVE: In this paper, we evaluate the role of FABP4 in pancreatic cancer progression. SETTING: University Hospital and Laboratories, United States. METHODS AND RESULTS: When Panc-1 (human) and Pan02 (mouse) pancreatic cancer cells were treated with FABP4 or the-single-point mutant FABP4 (R126Q, fatty acid binding site mutant), only FABP4 stimulated cellular proliferation. The transcriptional activity of nuclear factor E2-related factor 2 (NRF2) was increased in response to FABP4 but not the R126Q. FABP4 treatment also led to downregulation of reactive oxygen species (ROS) activity. Consistent with induced cell propagation by FABP4, the growth of Pan02 tumor was decreased in FABP4-null animals compared with C57BL/6J controls. CONCLUSION: These results suggest that FABP4 increases pancreatic cancer proliferation via activation of NRF2 and downregulation of ROS activity.


Assuntos
Proteínas de Ligação a Ácido Graxo/metabolismo , Fator 2 Relacionado a NF-E2 , Neoplasias Pancreáticas , Animais , Proliferação de Células , Proteínas de Ligação a Ácido Graxo/genética , Humanos , Camundongos , Camundongos Endogâmicos C57BL , Fator 2 Relacionado a NF-E2/genética , Fator 2 Relacionado a NF-E2/metabolismo
2.
J Biol Chem ; 292(24): 10220-10229, 2017 06 16.
Artigo em Inglês | MEDLINE | ID: mdl-28450398

RESUMO

Activating mutations in the receptor for C-type natriuretic peptide (CNP), guanylyl cyclase B (GC-B, also known as Npr2 or NPR-B), increase cellular cGMP and cause skeletal overgrowth, but how these mutations affect GTP catalysis is poorly understood. The A488P and R655C mutations were compared with the known mutation V883M. Neither mutation affected GC-B concentrations. The A488P mutation decreased the EC50 5-fold, increased Vmax 2.6-fold, and decreased the Km 13-fold, whereas the R655C mutation decreased the EC50 5-fold, increased the Vmax 2.1-fold, and decreased the Km 4.7-fold. Neither mutation affected maximum activity at saturating CNP concentrations. Activation by R655C did not require disulfide bond formation. Surprisingly, the A488P mutant only activated the receptor when it was phosphorylated. In contrast, the R655C mutation converted GC-B-7A from CNP-unresponsive to CNP-responsive. Interestingly, neither mutant was activated by ATP, and the Km and Hill coefficient of each mutant assayed in the absence of ATP were similar to those of wild-type GC-B assayed in the presence of ATP. Finally, 1 mm 2,4,6,-trinitrophenyl ATP inhibited all three mutants by as much as 80% but failed to inhibit WT-GC-B. We conclude that 1) the A488P and R655C missense mutations result in a GC-B conformation that mimics the allosterically activated conformation, 2) GC-B phosphorylation is required for CNP-dependent activation by the A488P mutation, 3) the R655C mutation abrogates the need for phosphorylation in receptor activation, and 4) an ATP analog selectively inhibits the GC-B mutants, indicating that a pharmacologic approach could reduce GC-B dependent human skeletal overgrowth.


Assuntos
Trifosfato de Adenosina/análogos & derivados , Doenças do Desenvolvimento Ósseo/genética , Inibidores Enzimáticos/farmacologia , Modelos Moleculares , Mutação , Peptídeo Natriurético Tipo C/metabolismo , Receptores do Fator Natriurético Atrial/antagonistas & inibidores , Trifosfato de Adenosina/farmacologia , Regulação Alostérica , Substituição de Aminoácidos , Doenças do Desenvolvimento Ósseo/metabolismo , GMP Cíclico/metabolismo , Guanosina Trifosfato/metabolismo , Células HEK293 , Humanos , Cinética , Mutagênese Sítio-Dirigida , Mutação de Sentido Incorreto , Fosforilação , Conformação Proteica , Processamento de Proteína Pós-Traducional , Receptores do Fator Natriurético Atrial/química , Receptores do Fator Natriurético Atrial/genética , Receptores do Fator Natriurético Atrial/metabolismo , Proteínas Recombinantes/química , Proteínas Recombinantes/metabolismo
3.
PLoS One ; 7(5): e36747, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22590601

RESUMO

Kinase homology domain (KHD) phosphorylation is required for activation of guanylyl cyclase (GC)-A and -B. Phosphopeptide mapping identified multiple phosphorylation sites in GC-A and GC-B, but these approaches have difficulty identifying sites in poorly detected peptides. Here, a functional screen was conducted to identify novel sites. Conserved serines or threonines in the KHDs of phosphorylated receptor GCs were mutated to alanine and tested for reduced hormone to detergent activity ratios. Mutation of Ser-489 in GC-B to alanine but not glutamate reduced the activity ratio to 60% of wild type (WT) levels. Similar results were observed with Ser-473, the homologous site in GC-A. Receptors containing glutamates for previously identified phosphorylation sites (GC-A-6E and GC-B-6E) were activated to ~20% of WT levels but the additional glutamate substitution for S473 or S489 increased activity to near WT levels. Substrate-velocity assays indicated that GC-B-WT-S489E and GC-B-6E-S489E had lower Km values and that WT-GC-B-S489A, GC-B-6E and GC-B-6E-S489A had higher Km values than WT-GC-B. Homologous desensitization was enhanced when GC-A contained the S473E substitution, and GC-B-6E-S489E was resistant to inhibition by a calcium elevating treatment or protein kinase C activation--processes that dephosphorylate GC-B. Mass spectrometric detection of a synthetic phospho-Ser-473 containing peptide was 200-1300-fold less sensitive than other phosphorylated peptides and neither mass spectrometric nor (32)PO(4) co-migration studies detected phospho-Ser-473 or phospho-Ser-489 in cells. We conclude that Ser-473 and Ser-489 are Km-regulating phosphorylation sites that are difficult to detect using current methods.


Assuntos
Receptores do Fator Natriurético Atrial/metabolismo , Substituição de Aminoácidos , Animais , Linhagem Celular , Humanos , Mutação de Sentido Incorreto , Mapeamento de Peptídeos/métodos , Peptídeos/genética , Peptídeos/metabolismo , Fosforilação/fisiologia , Estrutura Terciária de Proteína/fisiologia , Ratos , Receptores do Fator Natriurético Atrial/genética
4.
J Mol Cell Cardiol ; 51(1): 67-71, 2011 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-21459096

RESUMO

Designer natriuretic peptides (NPs) represent an active area of drug development. In canine and human studies, the designer natriuretic peptide CD-NP demonstrated more desirable therapeutic potential than recombinant B-type NP (BNP), which is known as nesiritide and is approved for treatment of acute decompensated heart failure. However, why CD-NP is more effective than BNP is not known. We previously reported that CD-NP is a poorer activator of human guanylyl cyclase-A (GC-A) and a better activator of human guanylyl cyclase-B than BNP. Here, guanylyl cyclase bioassays were used to compare the susceptibility of CD-NP verses ANP, BNP, CNP and DNP to inactivation by human kidney membranes. The half time (t(1/2)) for CD-NP inactivation was increased by factors of 13, 3 and 4 compared to ANP, BNP and CNP, respectively, when measured in the same assay. Surprisingly, DNP failed to undergo complete inactivation and was the most degradation resistant of the peptides tested. The neutral endopeptidase (NEP) inhibitor, phosphoramidon, blocked inactivation of CNP and CD-NP, but not BNP or DNP. In contrast, the general serine and cysteine protease inhibitor, leupeptin, completely blocked the degradation of BNP and CD-NP, but did not block CNP inactivation unless phosphoramidon was included in the assay. Thus, NPs with shorter carboxyl tails (ANP and CNP) are degraded by phosphoramidon-sensitive proteases and NPs with extended carboxyl tails (BNP, DNP and CD-NP) are resistant to NEP degradation and degraded by leupeptin-sensitive proteases. We conclude that DNP and CD-NP are highly resistant to proteolysis and that proteolytic resistance contributes to the beneficial cardiovascular properties of CD-NP. We suggest that this property may be exploited to increase the half-life of NP-based drugs.


Assuntos
Fator Natriurético Atrial/metabolismo , Venenos Elapídicos/metabolismo , Peptídeo Natriurético Encefálico/metabolismo , Peptídeo Natriurético Tipo C/metabolismo , Peptídeos/metabolismo , Fator Natriurético Atrial/farmacologia , Células Cultivadas , Inibidores de Cisteína Proteinase/farmacologia , Venenos Elapídicos/farmacologia , Glicopeptídeos/farmacologia , Células HEK293 , Humanos , Hidrólise , Peptídeos e Proteínas de Sinalização Intercelular , Rim/metabolismo , Leupeptinas/farmacologia , Peptídeo Natriurético Encefálico/farmacologia , Peptídeo Natriurético Tipo C/farmacologia , Neprilisina/antagonistas & inibidores , Peptídeos/farmacologia , Receptores do Fator Natriurético Atrial/metabolismo , Inibidores de Serina Proteinase/farmacologia
5.
Biochem Pharmacol ; 80(7): 1007-11, 2010 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-20599787

RESUMO

B-type natriuretic peptide (BNP) combats cardiac stress by reducing blood pressure and ventricular fibrosis. Human BNP is inactivated by unknown cell surface proteases. N-terminal cleavage of mouse BNP by the renal protease meprin A was reported to increase inactivating degradation by a second protease named neprilysin. Since the sequence surrounding the meprin A cleavage site in BNP differs between species, we tested whether meprin A degrades human BNP. Using a recently developed proteolytic bioassay, the ability of various protease inhibitors to block the inactivation of BNP was measured. In rat kidney membranes, inhibitors of meprin A or neprilysin partially or completely blocked inactivation of rat BNP(1-32) when added individually or in combination, respectively. In contrast, neither inhibitor alone or in combination prevented the inactivation of human BNP(1-32) by human kidney membranes. Leupeptin, a serine protease inhibitor, totally blocked inactivation of human BNP by human membranes, substantially blocked the inactivation of rat BNP(1-32) by human membranes, but had no effect on the inactivation of rat BNP(1-32) by rat kidney membranes. Purified neprilysin reduced the bioactivity of rat BNP(1-32) and human BNP. Digestion with both meprin and neprilysis caused the greatest reduction in rat BNP(1-32) but had no effect on the bioactivity of human BNP(1-32). We conclude that meprin A does not degrade BNP in humans and should not be considered a pharmacologic target of the natriuretic peptide system.


Assuntos
Peptídeo Natriurético Encefálico/sangue , Peptídeo Natriurético Encefálico/metabolismo , Animais , Pressão Sanguínea/efeitos dos fármacos , Endopeptidases/metabolismo , Endopeptidases/farmacologia , Humanos , Hidrólise , Rim/metabolismo , Leupeptinas , Metaloendopeptidases , Peptídeo Natriurético Encefálico/farmacologia , Neprilisina/antagonistas & inibidores , Neprilisina/metabolismo , Neprilisina/farmacologia , Peptídeo Hidrolases/metabolismo , Peptídeo Hidrolases/farmacologia , Inibidores de Proteases/metabolismo , Ratos , Serina Proteases
6.
Mol Pharmacol ; 78(3): 431-5, 2010 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-20530652

RESUMO

B-type natriuretic peptide (BNP) decreases cardiac preload and hypertrophy. As such, synthetic BNP, nesiritide, was approved for the treatment of acutely decompensated heart failure. However, two problems limit its therapeutic potential. First, ensuing hypertension decreases urine output, and second, guanylyl cyclase-A (GC-A), the primary signaling receptor for BNP, is down-regulated in heart failure. Thus, alternative or chimeric natriuretic peptides maintaining the renal but lacking the vasorelaxation properties of BNP provide an alternative approach. Here, we examined the ability of single amino acid substitutions in the conserved 17-amino acid disulfide ring structure of human BNP to activate GC-A and guanylyl cyclase-B (GC-B), which is not reduced in heart failure. We hypothesized that substitution of highly conserved residues in BNP with highly conserved residues from a GC-B-specific peptide would yield BNP variants with increased and decreased potency for human GC-B and GC-A, respectively. Substitution of Leu for Arg13 (l-bnp) yielded a 5-fold more potent activator of GC-B and 7-fold less potent activator of GC-A compared with wild type. l-bnp also bound GC-A 4.5-fold less tightly than wild type. In contrast, substitution of Met for Ser21 (M-BNP) had no effect. A peptide containing both the Leu and Met substitutions behaved similarly to l-bnp. Meanwhile, wild-type and l-bnp bound the natriuretic peptide clearance receptor with similar affinities. These data indicate that Arg13 of BNP is a critical discriminator of binding to guanylyl cyclase-linked but not clearance natriuretic peptide receptors, supporting designer natriuretic peptides as an alternative to wild-type BNP for the treatment of heart failure.


Assuntos
Guanilato Ciclase/metabolismo , Guanilato Ciclase/fisiologia , Peptídeo Natriurético Encefálico/metabolismo , Peptídeo Natriurético Encefálico/fisiologia , Regulação para Baixo , Guanilato Ciclase/genética , Insuficiência Cardíaca/genética , Insuficiência Cardíaca/metabolismo , Humanos , Hipertensão/genética , Hipertensão/metabolismo , Hipertrofia/genética , Rim/metabolismo , Peptídeo Natriurético Encefálico/genética , Peptídeos Natriuréticos/genética , Peptídeos Natriuréticos/metabolismo , Peptídeos/genética , Peptídeos/metabolismo , Receptores do Fator Natriurético Atrial , Receptores de Peptídeos/genética , Receptores de Peptídeos/metabolismo
7.
Proc Natl Acad Sci U S A ; 106(27): 11282-7, 2009 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-19541613

RESUMO

Alternative RNA splicing may provide unique opportunities to identify drug targets and therapeutics. We identified an alternative spliced transcript for B-type natriuretic peptide (BNP) resulting from intronic retention. This transcript is present in failing human hearts and is reduced following mechanical unloading. The intron-retained transcript would generate a unique 34 amino acid (aa) carboxyl terminus while maintaining the remaining structure of native BNP. We generated antisera to this carboxyl terminus and identified immunoreactivity in failing human heart tissue. The alternatively spliced peptide (ASBNP) was synthesized and unlike BNP, failed to stimulate cGMP in vascular cells or vasorelax preconstricted arterial rings. This suggests that ASBNP may lack the dose-limiting effects of recombinant BNP. Given structural considerations, a carboxyl-terminal truncated form of ASBNP was generated (ASBNP.1) and was determined to retain the ability of BNP to stimulate cGMP in canine glomerular isolates and cultured human mesangial cells but lacked similar effects in vascular cells. In a canine-pacing model of heart failure, systemic infusion of ASBNP.1 did not alter mean arterial pressure but increased the glomerular filtration rate (GFR), suppressed plasma renin and angiotensin, while inducing natriuresis and diuresis. Consistent with its distinct in vivo effects, the activity of ASBNP.1 may not be explained through binding and activation of NPR-A or NPR-B. Thus, the biodesigner peptide ASBNP.1 enhances GFR associated with heart failure while lacking the vasoactive properties of BNP. These findings demonstrate that peptides with unique properties may be designed based on products of alternatively splicing.


Assuntos
Processamento Alternativo/efeitos dos fármacos , Desenho de Fármacos , Rim/efeitos dos fármacos , Peptídeo Natriurético Encefálico/genética , Peptídeos/farmacologia , Sequência de Aminoácidos , Animais , Bovinos , Cães , Insuficiência Cardíaca/genética , Insuficiência Cardíaca/metabolismo , Insuficiência Cardíaca/patologia , Humanos , Dados de Sequência Molecular , Peptídeo Natriurético Encefálico/química , Peptídeo Natriurético Encefálico/metabolismo , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Receptores do Fator Natriurético Atrial/metabolismo
8.
J Biol Chem ; 284(29): 19196-202, 2009 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-19458086

RESUMO

A heterozygous frameshift mutation causing a 12-amino acid extension to the C terminus of atrial natriuretic peptide (ANP) was recently genetically linked to patients with familial atrial fibrillation (Hodgson-Zingman, D. M., Karst, M. L., Zingman, L. V., Heublein, D. M., Darbar, D., Herron, K. J., Ballew, J. D., de Andrade, M., Burnett, J. C., Jr., and Olson, T. M. (2008) N. Engl. J. Med. 359, 158-165). The frameshift product (fsANP), but not wild-type ANP (wtANP), was elevated in the serum of affected patients, but the molecular basis for the elevated peptide concentrations was not determined. Here, we measured the ability of fsANP to interact with natriuretic peptide receptors and to be proteolytically degraded. fsANP and wtANP bound and activated human NPR-A and NPR-C similarly, whereas fsANP had a slightly increased efficacy for human NPR-B. Proteolytic susceptibility was addressed with novel bioassays that measure the time required for kidney membranes or purified neutral endopeptidase to abolish ANP-dependent activation of NPR-A. The half-life of fsANP was markedly greater than that of wtANP in both assays. Additional membrane proteolysis studies indicated that wtANP and fsANP are preferentially degraded by neutral endopeptidase and serine peptidases, respectively. These data indicate that the familial ANP mutation associated with atrial fibrillation has only minor effects on natriuretic peptide receptor interactions but markedly modifies peptide proteolysis.


Assuntos
Fator Natriurético Atrial/metabolismo , Proteínas Mutantes/metabolismo , Mutação , Receptores do Fator Natriurético Atrial/metabolismo , Sequência de Aminoácidos , Animais , Fator Natriurético Atrial/sangue , Fator Natriurético Atrial/genética , Ligação Competitiva , Linhagem Celular , GMP Cíclico/metabolismo , Saúde da Família , Humanos , Hidrólise , Dados de Sequência Molecular , Proteínas Mutantes/sangue , Neprilisina/metabolismo , Ligação Proteica , Ratos , Receptores do Fator Natriurético Atrial/genética , Serina Endopeptidases/metabolismo
9.
J Biol Chem ; 283(50): 35003-9, 2008 Dec 12.
Artigo em Inglês | MEDLINE | ID: mdl-18940797

RESUMO

Synthetic atrial natriuretic peptide (carperitide) and B-type natriuretic peptide (BNP; nesiritide) are used to treat congestive heart failure. However, despite beneficial cardiac unloading properties, reductions in renal perfusion pressures limit their clinical effectiveness. Recently, CD-NP, a chimeric peptide composed of C-type natriuretic peptide (CNP) fused to the C-terminal tail of Dendroaspis natriuretic peptide (DNP), was shown to be more glomerular filtration rate-enhancing than BNP in dogs. However, the molecular basis for the increased responsiveness was not determined. Here, we show that the DNP tail has a striking effect on CNP, converting it from a non-agonist to a partial agonist of natriuretic peptide receptor (NPR)-A while maintaining the ability to activate NPR-B. This effect is specific for human receptors because CD-NP was only a slightly better activator of rat NPR-A due to the promiscuous nature of CNP in this species. Interesting, the DNP tail alone had no effect on any NPR even though it is effective in vivo. To further increase the potency of CD-NP for NPR-A, we converted two different triplet sequences within the CNP ring to their corresponding residues in BNP. Both variants demonstrated increased affinity and full agonist activity for NPR-A, whereas one was as potent as any NPR-A activator known. In contrast to a previous report, we found that DNP binds the natriuretic peptide clearance receptor (NPR-C). However, none of the chimeric peptides bound NPR-C with significantly higher affinity than endogenous ligands. We suggest that bifunctional chimeric peptides represent a new generation of natriuretic peptide therapeutics.


Assuntos
Peptídeos Natriuréticos/química , Sequência de Aminoácidos , Animais , Ligação Competitiva , Relação Dose-Resposta a Droga , Elapidae/metabolismo , Taxa de Filtração Glomerular , Humanos , Ligantes , Dados de Sequência Molecular , Peptídeo Natriurético Tipo C/química , Peptídeos/química , Estrutura Terciária de Proteína , Ratos , Proteínas Recombinantes de Fusão/química
10.
Am J Physiol Renal Physiol ; 292(5): F1636-44, 2007 May.
Artigo em Inglês | MEDLINE | ID: mdl-17264312

RESUMO

Atrial natriuretic peptide (ANP) and B-type natriuretic peptide decrease blood pressure and cardiac hypertrophy by activating natriuretic peptide receptor A (NPR-A), a transmembrane guanylyl cyclase also known as guanylyl cyclase A. Inactivation of NPR-A is a potential mechanism for the renal hyporesponsiveness observed in congestive heart failure (CHF) but direct data supporting this hypothesis are lacking. We examined whether NPR-A activity was reduced in CHF, and if so, by what mechanism. In two separate trials, CHF was induced in mice by 8-wk transverse aortic constriction. Sham controls underwent surgery without constriction. The constricted animals developed severe heart failure as indicated by increased heart weight, increased left ventricular end diastolic and systolic diameters, and decreased left ventricular ejection fractions. Kidney membranes were assayed for guanylyl cyclase activity or used to purify NPR-A by sequential immunoprecipitation/SDS-PAGE. Maximal ANP-dependent guanylyl cyclase activities were reduced by 44 or 43% in kidney membranes from CHF animals in two independent trials. Basal cyclase activities were also reduced by 31% in the second trial. The amount of phosphorylated NPR-A was reduced by 25 or 24% in kidney membranes from CHF animals as well. SYPRO Ruby staining suggested that NPR-A protein levels were similar between treatments in the first trial. However, more accurate estimates of NPR-A protein levels by immunoprecipitation/Western analysis in the second trial indicated that NPR-A protein was reduced by 30%. We conclude that reduced NPR-A protein levels, not receptor dephosphorylation, explain the renal hyporesponsiveness to natriuretic peptides in CHF.


Assuntos
Fator Natriurético Atrial/metabolismo , Insuficiência Cardíaca/fisiopatologia , Rim/fisiopatologia , Receptores do Fator Natriurético Atrial/deficiência , Animais , Aorta , Western Blotting , Cardiomegalia/diagnóstico por imagem , Cardiomegalia/etiologia , Constrição Patológica , Ecocardiografia , Guanilato Ciclase/metabolismo , Insuficiência Cardíaca/etiologia , Imunoprecipitação , Rim/enzimologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Compostos Organometálicos , Concentração Osmolar , Fosforilação , Receptores do Fator Natriurético Atrial/metabolismo , Coloração e Rotulagem
11.
Endocr Rev ; 27(1): 47-72, 2006 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-16291870

RESUMO

Natriuretic peptides are a family of structurally related but genetically distinct hormones/paracrine factors that regulate blood volume, blood pressure, ventricular hypertrophy, pulmonary hypertension, fat metabolism, and long bone growth. The mammalian members are atrial natriuretic peptide, B-type natriuretic peptide, C-type natriuretic peptide, and possibly osteocrin/musclin. Three single membrane-spanning natriuretic peptide receptors (NPRs) have been identified. Two, NPR-A/GC-A/NPR1 and NPR-B/GC-B/NPR2, are transmembrane guanylyl cyclases, enzymes that catalyze the synthesis of cGMP. One, NPR-C/NPR3, lacks intrinsic enzymatic activity and controls the local concentrations of natriuretic peptides through constitutive receptor-mediated internalization and degradation. Single allele-inactivating mutations in the promoter of human NPR-A are associated with hypertension and heart failure, whereas homozygous inactivating mutations in human NPR-B cause a form of short-limbed dwarfism known as acromesomelic dysplasia type Maroteaux. The physiological effects of natriuretic peptides are elicited through three classes of cGMP binding proteins: cGMP-dependent protein kinases, cGMP-regulated phosphodiesterases, and cyclic nucleotide-gated ion channels. In this comprehensive review, the structure, function, regulation, and biological consequences of natriuretic peptides and their associated signaling proteins are described.


Assuntos
GMP Cíclico/fisiologia , Peptídeos Natriuréticos/fisiologia , Receptores de Peptídeos/fisiologia , Transdução de Sinais/fisiologia , Animais , Transtornos do Crescimento/tratamento farmacológico , Cardiopatias/tratamento farmacológico , Humanos , Hipertensão/tratamento farmacológico , Peptídeos Natriuréticos/uso terapêutico , Obesidade/tratamento farmacológico , Estrutura Terciária de Proteína/fisiologia , Receptor Cross-Talk/fisiologia , Receptores de Peptídeos/agonistas , Receptores de Peptídeos/antagonistas & inibidores
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