Brain natriuretic peptide: a biomarker for all cardiac disease?

PURPOSE OF REVIEW: To evaluate new development in the utility of brain natriuretic peptide and N-Terminal brain natriuretic peptide (BNP/NT-Pro-BNP) in the management of various cardiovascular diseases. The determination of plasma BNP levels has an established role in the discrimination of pulmonary oedema from other causes of acute dyspnoea, and there is increasing evidence of the utility of BNP/NT-Pro-BNP assay both as a prognostic tool in chronic heart failure and as a means of guiding therapy in heart failure patients aged below 70 years. RECENT FINDINGS: Findings have substantially extended the clinical utility of BNP/NT-Pro-BNP assay. In heart failure with preserved left ventricular ejection fraction, BNP elevation may also facilitate diagnosis, although its precise utility is uncertain.In the acute catecholamine-induced myocardial inflammatory condition of Tako-Tsubo cardiomyopathy (TTC), BNP/NT-Pro-BNP elevations are marked and persist for at least 3 months, despite the absence of pulmonary oedema. In TTC, BNP/NT-Pro-BNP therefore serves as an ancillary diagnostic measure as well as a marker of recovery. Among other conditions in which BNP assay may provide prognostic information are atrial fibrillation (in which the extent of elevation predicts thromboembolic risk) and pulmonary hypertension. SUMMARY: BNP/NT-Pro-BNP assay has widespread utility as an adjunct to cardiovascular disease diagnosis and management.Gnanadevan Mahadavan, Thanh H. Nguyen, John D. Horowit

A roadmap toward the synthesis of life

The bigger pictureChallenges and opportunities:• Synthetic life deepens our understanding of the fundamental principles of life and can help unveil mechanisms that operated at life’s emergence. But it is more than just an academic pursuit—it opens the door to creating novel life forms with practical applications. From biotechnology and medicine to materials science, synthetic life has the potential to revolutionize industries and deliver tangible societal benefits.• Social, philosophical, and technical challenges, such as the lack of a broadly accepted definition, vague goals, misaligned interdisciplinary efforts, and public and ethical concerns, hinder the progress of synthesizing life.• This perspective offers a cross-disciplinary roadmap toward synthetic life that does not shy away from the challenges, ethical concerns, and provocative implications. Compiled over a 2-week workshop involving 57 scientists from 14 countries, we highlight technical and non-technical challenges for the scientific community to embrace a bold, unified vision for the future of synthetic life.SummaryThe synthesis of life from non-living matter has captivated and divided scientists for centuries. This bold goal aims at unraveling the fundamental principles of life and leveraging its unique features, such as its resilience, sustainability, and ability to evolve. Synthetic life represents more than an academic milestone—it has the potential to revolutionize biotechnology, medicine, and materials science. Although the fields of synthetic biology, systems chemistry, and biophysics have made great strides toward synthetic life, progress has been hindered by social, philosophical, and technical challenges, such as vague goals, misaligned interdisciplinary efforts, and incompletely addressing public and ethical concerns. Our perspective offers a roadmap toward the synthesis of life based on discussions during a 2-week workshop with scientists from around the globe