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human pro-ANP (31-67), also known as Vessel Dilator (VSDL) or MP3167, is a naturally occurring 37-amino acid peptide derived from the N-terminal region of the 126-amino acid atrial natriuretic peptide (ANP) prohormone. Developed by Madeleine Pharmaceuticals in association with the South Australian Health and Medical Research Institute, it is a biologic peptide therapeutic designed to treat cardiorenal complications. Unlike classic natriuretic peptides (such as ANP or BNP), human pro-ANP (31-67) does not bind to the canonical guanylyl cyclase-coupled natriuretic peptide receptors (NPR-A or NPR-B) and does not activate the cGMP pathway. Instead, it primarily induces natriuresis and diuresis by stimulating the generation and release of prostaglandin E2 (PGE2), which subsequently inhibits the Na+/K+-ATPase pump in the renal medullary collecting duct. It has a notably longer plasma half-life (~1.5 hours) compared to ANP or BNP and is resistant to degradation by neprilysin. The drug has been evaluated in the Phase 2 CONTINUUM-HF clinical trial in Australia for the treatment of acute decompensated congestive heart failure (ADCHF) in patients with impaired renal function (cardiorenal syndrome).
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