A DECADE OF ATRIAL-NATRIURETIC-FACTOR RESEARCH

Present views on the biological significance of atrial natriuretic factor (ANF) relate this polypeptide hormone to the regulation of blood pressure and volume through its modulating effects on renal function, on blood vessel tone and permeability, and on the renin-angiotensin-aldosterone system. Although very important advances in the understanding of ANF have been made over the decade since its discovery, some fundamental facts about ANF biosynthesis and release remain to be elucidated. Stretch-induced enhancement of ANF release appears as the most significant mechanism underlying the endocrine response of the atria to acute volume load. This response decays over a period of minutes, indicating that chronic stimulation of ANF release involves mechanisms different from, or in addition to, those acting during acute stretch-stimulated release. In neither acute nor chronic conditions are the cellular or molecular mechanisms underlying ANF release understood. To better understand long-term stimulation of ANF release, we have conducted extensive in vitro testing of several hormones and neurotransmitters to determine their ability to modify ANF release. From these studies, clear-cut evidence of ANF stimulation was obtained with the vasopressor peptide endothelin. Investigations on the cell and molecular biology of cardiac muscle development and hypertrophy have shown that ANF is involved in cardiac growth. The role played by ANF in these processes is now being determined, but this is one line of evidence that this hormone, together with other natriuretic peptides, may have autocrine or paracrine functions. Ten years after the discovery of ANF, much remains to be learned not only about ANF biosynthesis but also about details of the interaction of this hormone with its many targets. Nevertheless, the work accomplished to date has produced an astonishingly large amount of new knowledge ranging from new concepts in cell and molecular biology to the development of new therapeutic strategies for the treatment of hypertension and congestive heart failure.