Recent advances on natriuretic peptide system: new promising therapeutic targets for the treatment of heart failure.

Since the discovery of the influence of the endocrine system on cardiac endocrine function 30 years ago, an increasing number of experimental and clinical studies have consolidated endocrine function of human heart as being a relevant component of a complex network including endocrine, nervous and immune systems. Many aspects, however, still remain unclear as to the production, secretion and peripheral degradation pathways of B- and C-type natriuretic peptides. In particular, the hypothesis that the circulating plasma pool of the pro-hormone can function as precursor of the active peptide hormone is yet to be fully demonstrated. According to recent studies, peripheral processing of circulating pro-hormone likely undergoes regulation pathways which seem to be impaired in patients with heart failure. This would open new perspectives also in the treatment of heart failure, and identify novel pharmacological targets for drugs inducing and/or modulating the maturation of the pro-hormone into active hormone.