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Inicio Revista Colombiana de Cardiología Inhibición dual de la neprilisina y el receptor de angiotensina II: nueva estra...
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Vol. 20. Núm. 6.
Páginas 386-393 (noviembre - diciembre 2013)
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Vol. 20. Núm. 6.
Páginas 386-393 (noviembre - diciembre 2013)
Open Access
Inhibición dual de la neprilisina y el receptor de angiotensina II: nueva estrategia prometedora en el tratamiento de la enfermedad cardiovascular
Dual inhibition of neprilysin and angiotensin II receptor: promising new strategy in the treatment of cardiovascular disease
Visitas
16838
Fernando Manzur1,2,
Autor para correspondencia
fmanzur1954@hotmail.com

Correspondencia:.
, Tatiana Villarreal2, Carlos Moneriz3
1 Nuevo Hospital Bocagrande, Cartagena, Colombia
2 Universidad de Cartagena, Cartagena, Colombia
3 Laboratorio de Bioquímica, Facultad de Medicina, Universidad de Cartagena, Cartagena, Colombia
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La inhibición de neprilisina y el bloqueo de los receptores de angiotensina II, ofrecen beneficios potenciales para el tratamiento de las enfermedades cardiovasculares. El compuesto LCZ696 es el primer fármaco en fase de estudio como inhibidor de la neprilisina y de los receptores de angiotensina. El aumento de la concentración de los péptidos natriuréticos a través de la inhibición de la neprilisina, representa un enfoque terapéutico que tiene el potencial de conferir protección cardiaca, renal y vascular. Sin embargo, diversos estudios demuestran que los beneficios clínicos de la inhibición de la neprilisina pueden ser mejor aprovechados si se inhibe simultáneamente el sistema renina-angiotensina. Esta revisión realizada en PubMed, tiene como objetivo presentar los avances prometedores en el mecanismo dual de inhibición de la neprilisina y el receptor de angiotensina II para el tratamiento de la hipertensión y la insuficiencia cardiaca.

Palabras clave:
angiotensina
hipertensión
insuficiencia cardíaca
péptidos natriuréticos

Neprilysin inhibition and angiotensin II receptor blockade offer potential benefits for the treatment of cardiovascular diseases. The compound LCZ696 is the first drug under study phase as an inhibitor of neprilysin and angiotensin receptors. The increase of the concentration of the natriuretic peptides through the inhibition of neprilysin represents a therapeutic approach which has the potential of conferring cardiac, renal and vascular protection. However, several studies show that the clinical benefits of neprilysin inhibition can be better utilized if the renin-angiotensin system is simultaneously inhibited. This review realized in PubMed aims to present the promising advances in the dual mechanism of inhibition of neprilysin and angiotensin II receptor for the treatment of hypertension and heart failure.

Keywords:
angiotensin
hypertension
heart failure
natriuretic peptides
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Bibliografía
[1.]
C. Deaton, E.S. Froelicher, L.H. Wu, C. Ho, K. Shishani, T. Jaarsma.
The global burden of cardiovascular disease.
J Cardiovasc Nurs, 26 (2011), pp. S5-S14
[2.]
P.M. Kearney, M. Whelton, K. Reynolds, P. Muntner, P.K. Whelton, J. He.
Global burden of hypertension: analysis of worldwide data.
[3.]
Guías colombianas para el diagnóstico y tratamiento de la hipertensión arterial.
Rev Colomb Cardiol, 13 (2007), pp. 187-195
[4.]
Trial watch: dual inhibition shows promise in, hypertension.
Nat Rev Drug Discov, 9 (2010), pp. 350
[5.]
B. Waeber, F. Feihl.
Blood-pressure reduction with LCZ696.
The Lancet, 375 (2010), pp. 1228-1229
[6.]
H.A. Struijker-Boudier, E. Ambrosioni, H. Holzgreve, S. Laurent, G. Mancia, L.M. Ruilope, et al.
The need for combination antihypertensive therapy to reach target blood pressures: what has been learned from clinical practice and morbiditymortality trials?.
Int J Clin Pract, 61 (2007), pp. 1592-1602
[7.]
G. Mancia, G. De Backer, A. Dominiczak, R. Cifkova, R. Fagard, G. Germano, et al.
2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC).
J Hypertens, 25 (2007), pp. 1105-1187
[8.]
T. Unger, L. Paulis, D.A. Sica.
Therapeutic perspectives in hypertension: novel means for renin-angiotensin-aldosterone system modulation and emerging device-based approaches.
Eur Heart J, 32 (2011), pp. 2739-2747
[9.]
D. Aronson, H. Krum.
Novel therapies in acute and chronic heart failure.
Pharmacol Ther, 135 (2012), pp. 1-17
[10.]
L. Paulis, U.M. Steckelings, T. Unger.
Key advances in antihypertensive treatment.
Nat Rev Cardiol, 9 (2012), pp. 276-285
[11.]
S.D. Solomon, M. Zile, B. Pieske, A. Voors, A. Shah, E. Kraigher-Krainer, et al.
The angiotensin receptor neprilysin inhibitor LCZ696 in heart failure with preserved ejection fraction: a phase 2 double-blind randomised controlled trial.
The Lancet, 380 (2012), pp. 1387-1395
[12.]
L.M. Ruilope, A. Dukat, M. Böhm, Y. Lacourcière, J. Gong, M.P. Lefkowitz.
Bloodpressure reduction with LCZ696, a novel dual-acting inhibitor of the angiotensin II receptor and neprilysin: a randomised, double-blind, placebo-controlled, active comparator study.
The Lancet, 375 (2012), pp. 1255-1266
[13.]
J. Segura, J. Salazar, L.M. Ruilope.
Dual neurohormonal intervention in CV disease: angiotensin receptor and Neprilysin inhibition.
Expert Opin Investig Drugs, 22 (2013), pp. 915-925
[14.]
M.A. Weber.
Vasopeptidase inhibitors.
The Lancet, 358 (2001), pp. 1525-1532
[15.]
D.G. Gardner, S. Chen, D.J. Glenn, C.L. Grigsby.
Molecular biology of the natriuretic peptide system: implications for physiology and hypertension.
Hypertension, 49 (2007), pp. 419-426
[16.]
E.R. Levin, D.G. Gardner, W.K. Samson.
Natriuretic peptides.
N Engl J Med, 339 (1998), pp. 321-328
[17.]
J. Gu, A. Noe, P. Chandra, S. Al-Fayoumi, M. Ligueros-Saylan, R. Sarangapani, et al.
Pharmacokinetics and pharmacodynamics of LCZ696, a novel dual-acting angiotensin receptor-neprilysin inhibitor (ARNi).
J Clin Pharmacol, 50 (2010), pp. 401-414
[18.]
C.Y. Lee, J.C. Burnett Jr..
Natriuretic peptides and therapeutic applications.
Heart Fail Rev, 12 (2007), pp. 131-142
[19.]
S. Mangiafico, L.C. Costello-Boerrigter, I.A. Andersen, A. Cataliotti, J.C. Burnett Jr..
Neutral endopeptidase inhibition and the natriuretic peptide system: an evolving strategy in cardiovascular therapeutics.
Eur Heart J, 34 (2013), pp. 886-893
[20.]
G.F. Baxter.
The natriuretic peptides.
Basic Res Cardiol, 99 (2004), pp. 71-75
[21.]
L.R. Potter, S. Abbey-Hosch, D.M. Dickey.
Natriuretic peptides, their receptors, and cyclic guanosine monophosphate-dependent signaling functions.
Endocr Rev, 27 (2006), pp. 47-72
[22.]
E.G. Bevan, J.M. Connell, J. Doyle, H.A. Carmichael, D.L. Davies, A.R. Lorimer, et al.
Candoxatril, a neutral endopeptidase inhibitor: efficacy and tolerability in essential hypertension.
J Hypertens, 10 (1992), pp. 607-613
[23.]
D.J. Campbell.
Vasopeptidase inhibition: a double-edged sword?.
Hypertension, 41 (2003), pp. 383-389
[24.]
J.C. Burnett Jr..
Vasopeptidase inhibition: a new concept in blood pressure management.
J Hypertens Suppl, 17 (1999), pp. S37-S43
[25.]
J.B. Kostis, M. Packer, H.R. Black, R. Schmieder, D. Henry, E. Levy.
Omapatrilat and enalapril in patients with hypertension: the Omapatrilat Cardiovascular Treatment vs. Enalapril (OCTAVE) trial.
Am J Hypertens, 17 (2004), pp. 103-111
[26.]
G.F. Mitchell, J.L. Izzo Jr., Y. Lacourciere, J.P. Ouellet, J. Neutel, C. Qian, et al.
Omapatrilat reduces pulse pressure and proximal aortic stiffness in patients with systolic hypertension: results of the conduit hemodynamics of omapatrilat international research study.
Circulation, 105 (2002), pp. 2955-2961
[27.]
R.M. Fryer, J. Segreti, P.N. Banfor, D.L. Widomski, B.J. Backes, C.W. Lin, et al.
Effect of bradykinin metabolism inhibitors on evoked hypotension in rats: rank efficacy of enzymes associated with bradykinin-mediated angioedema.
Br J Pharmacol, 153 (2008), pp. 947-955
[28.]
F.H. Messerli, J. Nussberger.
Vasopeptidase inhibition and angio-oedema.
[29.]
M. Cicardi, L.C. Zingale, L. Bergamaschini, A. Agostoni.
Angioedema associated with angiotensin-converting enzyme inhibitor use: outcome after switching to a different treatment.
Arch Intern Med, 164 (2004), pp. 910-913
[30.]
L. Feng, P.H. Karpinski, P. Sutton, Y. Liu, D.F. Hook, B. Hu, et al.
LCZ696: a dual-acting sodium supramolecular complex.
Tetrahedron Letters, 53 (2012), pp. 275-276
[31.]
M.J. Bloch, J.N. Basile.
Combination angiotensin receptor blocker-neutral endopeptidase inhibitor provides additive blood pressure reduction over angiotensin receptor blocker alone.
J Clin Hypertens (Greenwich), 12 (2010), pp. 809-812
[32.]
C.S. Lam, E. Donal, E. Kraigher-Krainer, R.S. Vasan.
Epidemiology and clinical course of heart failure with preserved ejection fraction.
Eur J Heart Fail, 13 (2011), pp. 18-28
[33.]
B.M. Mearns.
Phase II PARAMOUNT trial of LCZ696.
Nat Rev Cardiol, 9 (2012), pp. 612
[34.]
S. Crunkhorn.
Trial watch: dual-acting combination meets heart failure end point.
Nat Rev Drug Discov, 11 (2012), pp. 740
[35.]
A. Martinez-Rumayor, A.M. Richards, J.C. Burnett, J.L. Januzzi Jr..
Biology of the natriuretic peptides.
Am J Cardiol, 101 (2008), pp. 3-8
[36.]
A.L. Birkenfeld, M. Boschmann, C. Moro, F. Adams, K. Heusser, G. Franke, et al.
Lipid mobilization with physiological atrial natriuretic peptide concentrations in humans.
J Clin Endocrinol Metab, 90 (2005), pp. 3622-3628
[37.]
A.L. Birkenfeld, F. Adams, C. Schroeder, S. Engeli, J. Jordan.
Metabolic actions could confound advantageous effects of combined angiotensin II receptor and neprilysin inhibition.
Copyright © 2013. Sociedad Colombiana de Cardiología y Cirugía Cardiovascular
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