Neutral endopeptidase inhibition potentiates the natriuretic actions of adrenomedullin. Lisy, Ondrej, Michihisa Jougasaki, John A. Schirger, Horng H. Chen, Paul T. Barclay, John C. Burnett. Cardiorenal Research Laboratory, Division of Cardiovascular Diseases, Department of Physiology, Mayo Clinic and Foundation, Rochester, Minnesota 55905
APStracts 5:0111F, 1998.
Adrenomedullin (ADM) is a potent renal vasodilating and natriuretic peptide possessing a six amino acid disulfide ring. Neutral endopeptidase 24.11 (NEP) is localized in greatest abundance in the kidney and cleaves endogenous peptides like ANP which also possesses a disulfide ring. We hypothesized that NEP inhibition potentiates the natriuretic actions of exogenous ADM in anesthetized dogs (n = 6). We therefore investigated renal function in which one kidney received intrarenal infusion of ADM (1ng/kg/min) while the contralateral kidney served as control before and during the systemic infusion of a NEP inhibitor (Candoxatrilat, Pfizer, UK, 8 (g/kg/min). In response to ADM, GFR in the ADM kidney did not change while RBF, urine flow (UV) and urinary sodium excretion (UNaV) increased from baseline. Proximal and distal fractional reabsorption of sodium decreased in the ADM infused kidney. In response to systemic NEP inhibition, UNaV and UV increased further in the ADM kidney. Indeed, (UNaV and (UV were markedly greater in the ADM kidney compared to the control kidney. Plasma ADM was unchanged during ADM infusion but increased during NEP inhibition. In conclusion, the present investigation is the first to demonstrate that NEP inhibition potentiates the natriuretic and diuretic responses to intrarenal ADM. This potentiation occurs secondary to a decrease in tubular sodium reabsorption. Lastly, the increase in plasma ADM during systemic NEP inhibition supports the conclusion that ADM is a substrate for NEP. 

Received 5 March 1998; accepted in final form 11 June 1998.
APS Manuscript Number F56-8.
Article publication pending Am. J. Physiol. (Renal Physiology).
ISSN 1080-4757 Copyright 1998 The American Physiological Society.
Published in APStracts on 30 July 1998