Vasopressin

1 Basal mechanisms of water-salt homeostasis.- 1.1 Body water distribution and osmotic concentration.- 1.2 Balance state.- 1.3 Regulation of extracellular fluid volume (the control of sodium balance).- 1.3.1 Reflex arc.- 1.3.2 Volume depletion.- 1.3.3 Volume expansion.- 1.4 Regulation of extracellular fluid osmolality (the control of water balance).- 1.4.1 Immediate, “first line” response to alterations of ECF osmolality.- 1.4.2 Osmoregulation at the cellular level.- 1.4.3 Osmoregulation at the level of the organism.- 2 Hypothalamo-neurohypophyseal hormones and neurophysins.- 2.1 Arginine-vasopressin (AVP) and lysine-vasopressin (LVP).- 2.2 Oxytocin (OT).- 2.3 Other naturally occurring nonapeptides in mammals.- 2.3.1 Arginine-vasotocin (AVT).- 2.3.2 Novel oxytocin-vasotocin-like material (OT-VT-like material).- 2.4 Neurohypophyseal peptides without established hormonal activity.- 2.4.1 Hormone-associated neurophysins (NP).- 2.4.2 Vasopressin-associated glycopeptide.- 3 Neurosecretion.- 3.1 Neural organization of the vasopressinergic system.- 3.1.1 Neurons producing vasopressin and oxytocin.- 3.1.2 Fiber projections of vasopressinergic neurons.- 3.1.3 Afferent inputs to the supraoptic and paraventricular nuclei.- 3.1.4 Immunoreactive vasopressin in peripheral tissues.- 4 Biosynthesis, transport and release of vasopressin.- 4.1 Structural organization of vasopressin gene.- 4.2 Posttranslational processing of the vasopressin precursor.- 4.3 Regulation of the vasopressin gene expression.- 4.4 The Brattleboro rat — an animal model of hereditary neurogenic (central) diabetes insipidus.- 4.5 Vasopressin release from the neurohypophysis.- 5 Regulation of vasopressin secretion and thirst.- 5.1 Osmoreceptor mediated regulation of vasopressin and thirst.- 5.1.1 Hypothalamic osmoreceptors and/or sodium sensors.- 5.1.2 Peripheral osmoreceptors and exteroceptive receptors (the potodiuretic reflex).- 5.1.3 Functional properties of the osmoregulatory system of vasopressin secretion.- 5.2 Functional properties of the osmoregulatory system regulating thirst.- 5.3 Functional relationship between osmotically stimulated AVP secretion and thirst.- 5.3.1 Changes in osmotic thresholds for vasopressin secretion and thirst.- 5.3.2 Changes in sensitivity of the osmoregulatory system of vasopressin secretion and thirst.- 5.4 Nonosmotic regulation of vasopressin secretion.- 5.4.1 Hemodynamic regulation of AVP secretion.- 5.4.2 Emetic regulation of vasopressin secretion.- 5.4.3 Glycopenic regulation of vasopressin secretion.- 5.4.4 Menstrual cycle and normal pregnancy.- 5.4.5 Pharmacologic agents and endotoxin.- 5.4.6 Hypoxia and hypercapnia.- 5.4.7 Intracranial hypertension.- 5.4.8 Stress.- 5.4.9 Ambient temperature.- 6 Vasopressin assays.- 6.1 Bioassays.- 6.2 Radioimmunoassays (RIA).- 6.2.1 Vasopressin in plasma.- 6.2.2 Vasopressin in urine.- 6.2.3 Vasopressin in cerebrospinal fluid.- 7 Receptors and synthetic analogs of vasopressin.- 7.1 Vasopressin receptors.- 7.1.1 V1 (pressor) receptors.- 7.1.2 V2 (antidiuretic) receptors.- 7.1.3 Novel vasopressin receptors.- 7.2 Regulation of vasopressin receptors.- 7.2.1 Receptor down- and upregulation.- 7.2.2 Multihormonal control of adenylate cyclase.- 7.2.3 Interactions between the V1 and V2 receptor signals; the role of endogenous prostaglandins.- 7.3 Synthetic analogs of vasopressin.- 7.3.1 Selective V2 (antidiuretic) agonists.- 7.3.2 Selective V1 (pressor) agonists.- 7.3.3 Selective V1 (pressor) antagonists.- 7.3.4 Selective V2 (antidiuretic) antagonists — “aquaretics”.- 8 Vasopressin and renal regulation of water homeostasis.- 8.1 Renal osmoregulatory performance —the osmotically free water concept.- 8.1.1 Generation and maintenance of a cortico-medullary osmotic gradient.- 8.1.2 Processes of generation of solute-free water and of the cortico-medullary osmotic gradient (countercurrent multiplier).- 8.1.3 Processes involved in the maintenance of the cortico-medullary osmotic gradient (medullary microcirculation).- 8.1.4 Utilization of the cortico-medullary osmotic gradient — the role of the collecting ducts.- 8.2 Renal actions by which vasopressin may affect the concentration of urine.- 8.2.1 Hydroosmotic action of vasopressin.- 8.2.2 Effects of vasopressin on the medullary thick ascending limb.- 8.2.3 Effect of vasopressin on urea permeability in the inner medullary collecting tubule and on medullary recycling of urea.- 8.2.4 Effect of vasopressin on the glomerular filtration rate (GFR).- 8.2.5 Effect of vasopressin on inner medullary blood flow.- 8.3 Urinary concentration.- 8.3.1 Urinary concentrating capacity and its disturbances.- 8.4 Clinical evaluation of renal concentrating performance.- 8.4.1 Maximal renal concentrating ability.- 8.4.2 Evaluation of patients with disturbed renal concentrating ability.- 8.5 Urine dilution and its disturbances.- 8.5.1 The renal diluting capacity and its disturbances.- 8.5.2 Clinical evaluation of renal diluting capacity.- 9 Vasopressin in circulatory control.- 9.1 Vasopressin-induced peripheral vasoconstriction.- 9.2 Blood pressure.- 9.3 Effects on the central nervous system.- 9.4 Role of vasopressin in blood pressure maintenance.- 9.4.1 Volume depleted states.- 9.4.2 Gastrointestinal bleeding.- 9.4.3 Arterial hypertension; SIADH.- 9.4.4 Congestive heart failure.- 9.4.5 Chronic orthostatic hypotension (autonomic failure).- 10 Vasopressin and hemostasis.- 10.1 Vasopressin and factor VIII complex.- 10.2 Vasopressin and fibrinolysis.- 10.3 Vasopressin and platelet function.- 10.4 Clinical experience with desmopressin in the treatment of various bleeding disorders.- 10.4.1 Von Willebrand’s disease.- 10.4.2 Hemophilia A.- 10.4.3 Various bleeding disorders.- 11 Vasopressin and anterior pituitary function.- 11.1 Vasopressin and adrenocorticotropic hormone (ACTH) release.- 11.2 Vasopressin and other anterior pituitary hormones.- 12 Vasopressin and brain function.- 12.1 Vasopressin in cerebrospinal fluid.- 12.1.1 The role of CSF vasopressin.- 12.1.2 Regulation of vasopressin secretion into the CSF.- 12.1.3 Circadian regulation of CSF vasopressin.- 12.1.4 Vasopressin in human CSF.- 12.2 Vasopressin and memory.- 12.2.1 Behavioral effects of vasopressin.- 12.2.2 Relationship of AVP to other behaviorally active neuropeptides (ACTH and OT).- 12.2.3 Nature of the behavioral actions of vasopressin.- 12.2.4 Vasopressin and human behavior.- 13 Metabolic effects of vasopressin.- 14 Clinical disturbances of vasopressin secretion and effects (hypo- and hyper-vasopressinism).- 14.1 Hypovasopressinism.- 14.2 Hypervasopressinism.- 14.3 Role of water intake and fluid therapy.- 14.4 Iatrogenic disturbances in body water homeostasis.- 15 Ontogenesis of body water homeostasis and vasopressin secretion.- 15.1 Fetal neurohypophyseal function.- 15.1.1 Arginine-vasotocin in fetuses.- 15.1.2 Vasopressin secretion in fetuses.- 15.1.3 Effects of vasopressin in fetuses.- 15.2 Vasopressin during the labor.- 15.3 Regulation of body water homeostasis and vasopressin secretion in newborns and young infants.- 15.3.1 Developmental changes in body fluid volume and distribution.- 15.3.2 Metabolic state of newborns and young infants.- 15.3.3 Postnatal development of renal handling of salt and water.- 15.4 Arginine-vasopressin during the immediate postnatal period.- 15.5 Development of vasopressin secretion from birth to adulthood.- 15.6 Circadian variations of vasopressin secretion and nocturnal enuresis in children.- 15.6.1 Desmopressin treatment of enuresis in children.- 16 Renal water handling, vasopressin secretion and thirst sensation in the elderly.- 16.1 Aging and renal function.- 16.2 Aging and vasopressin secretion.- 16.3 Aging and thirst.- 17 Clinical syndromes associated with hypovasopressinism.- 17.1 Disturbed vasopressin secretion (central diabetes insipidus, CDI).- 17.1.1 Etiology of central diabetes insipidus.- 17.1.2 Central diabetes insipidus in infancy and childhood.- 17.1.3 Central diabetes insipidus in pregnancy.- 17.1.4 Therapy of central diabetes insipidus.- 17.2 Nephrogenic diabetes insipidus (NDI).- 17.2.1 Familial nephrogenic diabetes insipidus.- 17.2.2 Acquired nephrogenic diabetes insipidus.- 17.2.3 Therapy of nephrogenic diabetes insipidus.- 17.3 Disturbed osmoregulation of thirst and vasopressin secretion (hypovasopressinism without polyuria; essential hypernatremia).- 17.4 Increased thirst with secondary hypovasopressinism — polydipsic diabetes insipidus, PDI.- 17.5 Differential diagnosis of polyuric syndromes.- 17.5.1 Osmotic polyuria.- 17.5.2 Solute-free water polyuria.- 18 Hypertonic syndromes.- 18.1 Hypertonicity and the central nervous system.- 18.2 Hypernatremia.- 18.2.1 Hypernatremia due to “pure” water loss (hypernatremia with normal total body sodium).- 18.2.2 Hypernatremia due to hypotonic loss (hypernatremia with low total body sodium).- 18.2.3 Hypernatremia due to salt gain (hypernatremia with increased total body sodium).- 18.3 Treatment of hypernatremia.- 19 Hypervasopressinism.- 19.1 Causes of hypervasopressinism.- 19.2 Hypervasopressinism — is it always inappropriate?.- 20 The hypotonic syndrome.- 20.1 Non-hypotonic hyponatremias.- 20.1.1 Pseudohyponatremia.- 20.1.2 Redistribution of body water.- 20.2 Hypotonicity and the central nervous system.- 20.3 Hypotonic (“true”) hyponatremia.- 20.3.1 Hypotonic hyponatremia associated with normal body sodium (“normovolemic” hyponatremia, syndrome of inappropriate secretion of antidiuretic hormone, SIADH).- 20.3.2 Hypotonic hyponatremia associated with reduced body sodium (hypovolemic hyponatremia).- 20.3.3 Hypotonic hyponatremia associated with increased body sodium (hypervolemic hyponatremia).- 20.4 Treatment of hyponatremia.- 20.4.1 Hypovolemic hypotonic hyponatremia.- 20.4.2 Normovolemic hypotonic hyponatremia (syndrome of inappropriate secretion of antidiuretic hormone, SIADH).- 20.4.3 Hypervolemic hypotonic hyponatremia.- List of abbreviations.- References.