Winter 2008-2009 - Mayo Clinic

I
t relieves pressure on a failing heart, boosts kidney
function to help clear the body of excess salt (natriuresis)
and water, and may just be the newest emergency cardiac
“super” drug.
It is CD-NP, a chimeric protein rationally designed by
Mayo Clinic physician-scientists John Burnett, M.D., and
Ondrej Lisy, M.D., Ph.D. CD-NP is created by fusing a portion
of the amino acid sequence of the recently discovered
Dendroaspis natriuretic peptide (DNP) to a core structure
of the human vasodilatory and antifibrotic protein C-type
natriuretic peptide (CNP).
Dr. Burnett calls the result of this synthesis a unique
“super-natriuretic peptide.” He is director of Mayo Clinic’s
Cardiorenal Research Laboratory, a consultant in the
divisions of Cardiovascular Diseases and Physiology and
Biophysics, and the Marriott Family Professor of
Cardiovascular Research.
“CD-NP has therapeutic potential to treat acute and
chronic congestive heart failure, and also improve renal
function in patients undergoing heart surgery,” says
Dr. Burnett. He and Dr. Lisy, a fellow in Cardiovascular
Diseases and an assistant professor of medicine, have
worked for several years to create CD-NP.
It’s a bird,
it’s a plane, it’s a
super-natriuretic peptide!
“Our new drug is carefully designed to improve
kidney function and relieve congestion in patients who
have congestive heart failure,” says Dr. Lisy. “Most of the
currently used drugs either worsen or do not improve
renal function. This is a significant clinical problem.”
In congestive heart failure, a chronic condition, the
heart cannot effectively pump enough blood to the body’s
other organs. Heart failure affects 5.3 million Americans
and is a significant and growing public health problem.
More than 650,000 new cases are diagnosed every
year. In heart failure, worsening kidney function is an
independent predictor of morbidity and mortality in
heart failure.
“The real elegance of this drug is the idea of exploiting
the desirable properties of two peptides,” says Dr. Burnett.
“We’re very excited about this combination drug. It has
a lot of potential to aid patients in heart failure whose
recovery might otherwise be hampered by subsequent
kidney function. CD-NP is designed to be administered
intravenously, but we envision new technologies in which
we can turn this into a product that can be taken orally, like
any other pill. You could have IV treatment in the hospital,
then go home and follow up with a pill.”
20 | Mayo Alumni Winter 2009