If the lungs are synthesizing and secreting a large amount of the N-terminus and C-terminus of the ANF prohormone in persons with congestive heart failure, it is possible that their nearly equal concentrations in the plasma and pleural fluid of patients with congestive heart failure is due to the lung producing a significant amount of the plasma concentration of both the N-terminus and C-terminus of the ANF prohormone, as well as their pleural fluid concentrations in this disease. flovent inhaler
The N-terminus of the ANF prohormone contains peptides (ie, pro ANF 1-30 and pro ANF 31-67) with similar diuretic and natriuretic properties to ANF. The finding of the whole N-terminus of the prohormone and pro ANF 31-67 itself in the pleural fluid suggests the possibility that these peptides are secreted along with ANF into the pleural fluid to help clear the fluid present in the pleural space. ANF has been shown to have a protective effect on the production of pulmonary edema in a study where 200 ng/ml of ANF was added 3 to 5 minutes before the infusion of various chemicals which cause pulmonary edema in isolated perfused lungs. This protective effect was not secondary to the systemic natriuretic or diuretic action of ANF since this was an isolated lung preparation. Although the mechanism of the protective effect on the production of ANF was not defined in this study, it does suggest that ANF secreted locally by the lung may have a local protective mechanism to prevent the formation of fluid in the lung.
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