Our Central Theme of this Program Project revised application continues to be to accelerate our efforts to translate the biology of the endogenous particulate guanylyl cyclase (GC) activators, the natriuretic peptides (NPs), into novel therapeutics for human cardiorenal disease highly relevant to heart failure and hypertension. This is motivated by the biology, therapeutics and diagnostics of the NPs and their GC receptors linked to 3',5'cyclic guanosine monophosphate (cGMP). Indeed, studies at the molecular or cell level, in murine or large animal models, in pharmacologic or physiologic studies in normal or humans with cardiovascular or renal disease and in recent human of NP gene variants have provided a view of a humoral system with broad beneficial pleiotropic actions. These beneficial properties of NP/GC/cGMP signaling include natriuresis, vasodilatation, positive lusitropism, inhibition of myocyte apoptosis and hypertrophy, inhibition of fibroblast proliferation and collagen synthesis, suppression of aldosterone and induction of vascular regeneration. Indeed, these cGMP-mediated properties of GC receptor activation linked to the NPs represent an unprecedented opportunity for novel drug discovery. Highlights of each Project are as follows: Project 1: Enhance cardiomyocyte function through chronic overexpression of the GC-A receptor utilizing a novel gene delivery strategy in experimental diastolic heart failure (Margaret Redfield MD - Project Leader);Project 2: Advance the development of oral delivery in humans of the designer NP CD-NP and the development of a second novel GC-A/-B activator individualized for cardiorenal disease (John C Burnett Jr., MD - Project Leader);Project 3: Establish in humans with systolic and diastolic preclinical heart failure with impaired renal function the synergistic action of optimizing the NP/PDEV/cGMP pathway with chronic PDEV inhibition with chronic novel GC-A activation (Dr. Horng Chen MD - Project Leader). Thus, this application brings together a highly collaborative team of physician-scientists with a highly translational proposal which should lead to innovative therapeutics for cardiorenal disease.

Public Health Relevance

Cardiovascular and renal disease is increasing worldwide and leads to heart failure and kidney failure. An unmet need is novel therapeutics for prevention and treatment of cardiorenal disease often occurring in the setting of hypertension, atherosclerosis and diabetes. Our proposal has high impact and significance as its translational strategies will accelerate biology to new drugs.

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Research Program Projects (P01)
Project #
Application #
Study Section
Heart, Lung, and Blood Initial Review Group (HLBP)
Program Officer
Sopko, George
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Mayo Clinic, Rochester
United States
Zip Code
Lee, Candace Y W; Huntley, Brenda K; McCormick, Daniel J et al. (2016) Cenderitide: structural requirements for the creation of a novel dual particulate guanylyl cyclase receptor agonist with renal-enhancing in vivo and ex vivo actions. Eur Heart J Cardiovasc Pharmacother 2:98-105
Mohammed, Selma F; Majure, David T; Redfield, Margaret M (2016) Zooming in on the Microvasculature in Heart Failure With Preserved Ejection Fraction. Circ Heart Fail 9:
Wan, Siu-Hin; McKie, Paul M; Schirger, John A et al. (2016) Chronic Peptide Therapy With B-Type Natriuretic Peptide in Patients With Pre-Clinical Diastolic Dysfunction (Stage B Heart Failure). JACC Heart Fail 4:539-47
Patel, Pratik A; Scott, Christopher G; Rodeheffer, Richard J et al. (2016) The Natural History of Patients With Isolated Metabolic Syndrome. Mayo Clin Proc 91:623-33
Wan, Siu-Hin; Stevens, Susanna R; Borlaug, Barry A et al. (2016) Differential Response to Low-Dose Dopamine or Low-Dose Nesiritide in Acute Heart Failure With Reduced or Preserved Ejection Fraction: Results From the ROSE AHF Trial (Renal Optimization Strategies Evaluation in Acute Heart Failure). Circ Heart Fail 9:
Sangaralingham, S Jeson; Wang, Bing H; Huang, Li et al. (2016) Cardiorenal fibrosis and dysfunction in aging: Imbalance in mediators and regulators of collagen. Peptides 76:108-14
McKie, Paul M; Schirger, John A; Benike, Sherry L et al. (2016) Chronic subcutaneous brain natriuretic peptide therapy in asymptomatic systolic heart failure. Eur J Heart Fail 18:433-41
Holditch, Sara J; Schreiber, Claire A; Burnett, John C et al. (2016) Arterial Remodeling in B-Type Natriuretic Peptide Knock-Out Females. Sci Rep 6:25623
AbouEzzeddine, Omar F; French, Benjamin; Mirzoyev, Sultan A et al. (2016) From statistical significance to clinical relevance: A simple algorithm to integrate brain natriuretic peptide and the Seattle Heart Failure Model for risk stratification in heart failure. J Heart Lung Transplant 35:714-21
Holditch, Sara J; Schreiber, Claire A; Nini, Ryan et al. (2015) B-Type Natriuretic Peptide Deletion Leads to Progressive Hypertension, Associated Organ Damage, and Reduced Survival: Novel Model for Human Hypertension. Hypertension 66:199-210

Showing the most recent 10 out of 118 publications