Research Paper on As a novel method of treating right heart failure in the setting of chronic obstructive pulmonary disease, neprilysin inhibitors

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Title: As a novel method of treating right heart failure in the setting of chronic obstructive pulmonary disease, neprilysin inhibitors

Abstract: Reviewing the research on the potential use of angiotensin II receptor antagonist and neprilysin inhibitors (ARNI) in patients with right heart failure (RHF) who are suffering from chronic obstructive pulmonary disease (COPD) was the main goal of this paper. It has been established that the platelet-derived growth factor (PDGF), which promotes the proliferation and migration of pulmonary artery smooth muscle cells as well as the endothelial-to-senchymal transition, is responsible for the exacerbation of pulmonary arterial remodelling (PAR) or pulmonary hypertension (PH) in hypoxia. Such an action during the course of COPD may result in RHF, which would indicate a harmful effect of this class of medications. Neprilysin inhibition, however, also interferes with the metabolism of natriuretic peptides. Brain natriuretic peptide (BNP), the representative of this class, acts as a vasodilator and also has antiproliferative effects via the cGMP-dependent protein kinase G pathway. Additionally, it induces the release of acetylcholine from bronchial epithelial cells, which results in bronchodilation. This implies that natriuretic peptides may show promise as a treatment for patients with COPD and cardiac complications. Patients with acute lung injury brought on by pulmonary inflammation during COPD exacerbations may benefit from their effects associated with the immunosuppressive capacity by reducing the release of inflammatory mediators — IL-6, IL-1b, and TNF-a. Further investigation is necessary in this area to produce strong scientific evidence supporting the need for adding ARNI drugs to the treatment of COPD patients given the potential beneficial effect of natriuretic peptides in this population of patients.

Keywords: sacubitril, neprilysin, natriuretic peptides, right heart failure, chronic obstructive pulmonary disease

Paper Quality: SCOPUS / Web of Science Level Research Paper

Subject: Advances in Respiratory Medicine

Writer Experience: 20+ Years

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