Diabetic neuropathy and heart failure: role of neuropeptides

Asma Ejaz; Frank W. LoGerfo; Leena Pradhan

doi:10.1017/S1462399411001979

Diabetic neuropathy and heart failure: role of neuropeptides

Published online by Cambridge University Press: 10 August 2011

Asma Ejaz ,

Frank W. LoGerfo and

Leena Pradhan

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Asma Ejaz: Affiliation:
Department of Surgery, Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
Frank W. LoGerfo: Affiliation:
Department of Surgery, Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
Leena Pradhan*: Affiliation:
Department of Surgery, Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
*: *Corresponding author: Leena Pradhan, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Dana-805, Boston, MA, USA. E-mail: lpradhan@bidmc.harvard.edu

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Abstract

Cardiovascular autonomic neuropathy (CAN), in which patients present with damage of autonomic nerve fibres, is one of the most common complications of diabetes. CAN leads to abnormalities in heart rate and vascular dynamics, which are features of diabetic heart failure. Dysregulated neurohormonal activation, an outcome of diabetic neuropathy, has a significant pathophysiological role in diabetes-associated cardiovascular disease. Key players in neurohormonal activation include cardioprotective neuropeptides and their receptors, such as substance P (SP), neuropeptide Y (NPY), calcitonin-gene-related peptide (CGRP), atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP) and C-type natriuretic peptide (CNP). These neuropeptides are released from the peripheral or autonomic nervous system and have vasoactive properties. They are further implicated in cardiomyocyte hypertrophy, calcium homeostasis, ischaemia-induced angiogenesis, protein kinase C signalling and the renin–angiotensin–aldosterone system. Therefore, dysregulation of the expression of neuropeptides or activation of the neuropeptide signalling pathways can negatively affect cardiac homeostasis. Targeting neuropeptides and their signalling pathways might thus serve as new therapeutic interventions in the treatment of heart failure associated with diabetes. This review discusses how neuropeptide dysregulation in diabetes might affect cardiac functions that contribute to the development of heart failure.

Type: Review Article
Information: Expert Reviews in Molecular Medicine , Volume 13 , March 2011 , e26

DOI: https://doi.org/10.1017/S1462399411001979 [Opens in a new window]
Copyright: Copyright © Cambridge University Press 2011

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Diabetic neuropathy and heart failure: role of neuropeptides

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Diabetic neuropathy and heart failure: role of neuropeptides

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