PT - JOURNAL ARTICLE AU - Krishna D. B. Anapindi AU - Elena V. Romanova AU - James W. Checco AU - Jonathan V. Sweedler ED - Hook, Vivian TI - Mass Spectrometry Approaches Empowering Neuropeptide Discovery and Therapeutics AID - 10.1124/pharmrev.121.000423 DP - 2022 Jul 01 TA - Pharmacological Reviews PG - 662--679 VI - 74 IP - 3 4099 - http://pharmrev.aspetjournals.org/content/74/3/662.short 4100 - http://pharmrev.aspetjournals.org/content/74/3/662.full SO - Pharmacol Rev2022 Jul 01; 74 AB - The discovery of insulin in the early 1900s ushered in the era of research related to peptides acting as hormones and neuromodulators, among other regulatory roles. These essential gene products are found in all organisms, from the most primitive to the most evolved, and carry important biologic information that coordinates complex physiology and behavior; their misregulation has been implicated in a variety of diseases. The evolutionary origins of at least 30 neuropeptide signaling systems have been traced to the common ancestor of protostomes and deuterostomes. With the use of relevant animal models and modern technologies, we can gain mechanistic insight into orthologous and paralogous endogenous peptides and translate that knowledge into medically relevant insights and new treatments. Groundbreaking advances in medicine and basic science influence how signaling peptides are defined today. The precise mechanistic pathways for over 100 endogenous peptides in mammals are now known and have laid the foundation for multiple drug development pipelines. Peptide biologics have become valuable drugs due to their unique specificity and biologic activity, lack of toxic metabolites, and minimal undesirable interactions. This review outlines modern technologies that enable neuropeptide discovery and characterization, and highlights lessons from nature made possible by neuropeptide research in relevant animal models that is being adopted by the pharmaceutical industry. We conclude with a brief overview of approaches/strategies for effective development of peptides as drugs.Significance Statement Neuropeptides, an important class of cell-cell signaling molecules, are involved in maintaining a range of physiological functions. Since the discovery of insulin’s activity, over 100 bioactive peptides and peptide analogs have been used as therapeutics. Because these are complex molecules not easily predicted from a genome and their activity can change with subtle chemical modifications, mass spectrometry (MS) has significantly empowered peptide discovery and characterization. This review highlights contributions of MS-based research towards the development of therapeutic peptides.