Difference Between NT-proBNP and BNP

B-type Natriuretic Peptide (B-type Natriuretic Peptide; Brain Natriuretic Peptide, BNP) is one of the most sensitive and specific markers of cardiac dysfunction, and the most influential cardiac marker at the beginning of the new century. The laboratory index, its significance is epoch-making.

From November 22, 2000, the FDA approved a US company's BNP test for the diagnosis of congestive heart failure (CHF) so far, BNP has now been widely used in clinical practice.

一、Similarities and differences between BNP and NT-proBNP

1.Cardiomyocytes first synthesize 108 amino acid proBNP, which is divided into 76 amino acid NT-proBNP and 32 amino acid BNP by endonuclease.

2.There is a very important disulfide bond in the molecular structure of BNP to form a ring structure, which can bind to the natriuretic peptide receptor to exert biological activity: NT-proBNP is a straight chain structure and is an amino acid fragment that loses biological activity.

3.The clearance of BNP is mainly through the binding of natriuretic peptide clearance receptor (NPR-C), followed by endocytosis and lysosomal degradation. Only a small amount of BNP is cleared by the kidneys. When the renal function is lost, NEP can also open the ring structure of BNP. It is cleared; the only way NT-proBNP is cleared is by glomerular filtration, and the absence of renal function has a major impact on the metabolism of NT-proBNP.

4.The half-life of BNP was 22min, while that of NT-proBNP was 120min. From the perspective of clinical testing, NT-proBNP is relatively stable in vitro, which brings convenience to the detection. However, from the perspective of clinical application, the shorter half-life of BNP can better reflect the changes of the patient's condition, which is beneficial to clinical simplicity. The therapeutic effect of the book will bring better clinical application value.

二、The difference between the clinical application value of BNP and NT-proBNP

    Both BNP and NT-proBNP are certified by the US FDA. Both BNP and NT-proBNP play a role in the diagnosis, prognosis, and management of heart failure, but the two are not the same. The table lists the important differences between BNP and NT-proBNP.

    Recent studies have reported minimal loss of BNP with EDTA anticoagulation. BNP is more stable in plastic tubes than glass tubes.  

 -------------Selected from Clinical Application and Recent Progress of B-type urinary natriuretic Peptide by Hu Dayi