The third function of atrial natriuretic peptide – the role of vascular permeability and endothelial glycocalyx

Abstract

The clinical efficacy of atrial natriuretic peptide (ANP) has been well investigated in several clinical conditions such as acute heart failure and perioperative period of cardiovascular surgery, no definite evidence has been yet obtained. Moreover, the role of ANP in controlling vascular permeability are not known. It has been reported that the regulation of intravascular fluid volume and cardiac preload by ANP is strongly associated with its vascular permeability-enhancing action, in addition to its diuretic action and vasodilatory action. Furthermore, ANP has been also known to inhibit the hyperpermeability of damaged vascular endothelial cells and protect the endothelial cell barrier function. Apart from these actions, ANP has recently been suspected of degrading the endothelial glycocalyx. ANP affects both vascular endothelial cells and their glycocalyx coating, and may, therefore, play an important role in modulating in vivo vascular permeability.