Diabetes insipidus vasopressin

Stmctural defects at the receptor level are determinant for a number of receptor diseases. In nephrogenic diabetes insipidus, where patients void large volumes of dilute urine even in the presence of vasopressin (antidiuretic hormone) (105), the disease is linked to mutations in three discrete regions of the G-protein-linked vasopressin (V2) receptor (106,107). 

Robben JH, Knoers NV, Deen PM (2006) Cell biological aspects of the vasopressin 1ype-2 receptor and aquaporin 2 water channel in nephrogenic diabetes insipidus. Am J Physiol Renal Physiol 291 F257-F270... 

X-linked nephrogenic diabetes insipidus Vasopressin V2 receptor (V2R) SR121463, SR49059... 

X-linked nephrogenic diabetes insipidus (NDI) is caused by mutations in the gene for the vasopressin V2 receptor leading to an insensitivity of the kidney for the antidiuretic hormone arginine vasopressin (AVP). The main symptom of the disease is diuresis, i.e., the production of a large amount of diluted urine. Due to the massive loss of water, the patients suffer from thirst and are in danger of dehydration. The disease usually becomes evident shortly after birth. 

Vasopressin and its derivatives are used in die treatment of diabetes insipidus, a disease resulting from die failure of the pituitary to secrete vasopressin or from surgical removal of die pituitary. Diabetes insipidus is characterized by marked increase in urination (as much as 10 L in 24 hours) and excessive tiiirst by inadequate secretion of die antidiuretic hormone or vasopressin. Treatment with vasopressin therapy replaces die hormone in the body and restores normal urination and thirst Vasopressin may also be used for die prevention and treatment of postoperative abdominal distention and to dispel gas interfering with abdominal roentgenography. 

Before administering die first dose of vasopressin for die management of diabetes insipidus, die nurse takes die patient s blood pressure, pulse, and respiratory rate. The nurse weighs the patient to obtain a baseline weight for future comparison. Serum electrolyte levels and odier laboratory tests may be ordered by die primary health care provider. 

Diabetes insipidus occurs with a loss of vasopressin production in the Brattleboro rat model 330 Mutations and knockouts of peptide-processing enzyme genes cause a myriad of physiological problems 330 Neuropeptides play key roles in appetite regulation and obesity 330 Enkephalin knockout mice reach adulthood and are healthy 331 Neuropeptides are crucial to pain perception 331... 

Diabetes insipidus occurs with a loss of vasopressin production in the Brattleboro rat model. In the... 

Nephrogenic diabetes insipidus (NDI) is characterized by renal tubular resistance to the antidiuretic effect of arginine vasopressin (AVP). NDI may be inherited as an autosomal dominant or X-linked recessive disorder. The autosomal dominant form of NDI results from mutations of the aquaporin 2 gene (AQP2). AQP2 encodes a water channel of the renal collecting duct. Its disruption causes autosomal dominant NDI (113,114) and occasionally recessive forms of the disease. 

Bichet, D. G., Turner, M., and Morin, D. (1998) Vasopressin receptor mutations causing nephrogenic diabetes insipidus. Proc. Assoc. Am. Physicians. 110, 387-394. 

Szalai, C., Triga, D., and Czinner, A. (1998) C112R, W323S, N317K mutations in the vasopressin receptor gene in patients with nephrogenic diabetes insipidus. Mutations in brief no. 165. Online. Hum. Mutat. 12, 137-138. 

Oksche, A., Dickson, J., Schulein, R., et al. (1994) Two novel mutations in the vasopressin Vj receptor gene in patients with congenital nephrogenic diabetes insipidus. Biochem. Biophys. Res. Common. 205, 552-527. 

Pan, Y., Metzenberg, A., Das, S., ling, B., and Gitschier, J. (1992) Mutations in the vasopressin receptor gene are associated with X-Unked nephrogenic diabetes insipidus. Nat. 

Rosenthal, W., Seibold, A., Antaramian, A., et al. (1994) Mutations in the vasopressin receptor gene in families with nephrogenic diabetes insipidus and functional expression of the Q-2 mutant. Cell. Mol. Biol. (Noisy-Le-Grand). 40, 429 36. 

Rosenthal, W., Antaramian, A., Gilbert, S., and Birnbaumer, M. (1993) Nephrogenic diabetes insipidus. A vasopressin receptor unable to stimulate adenylyl cyclase. J. Biol. Chem. 268, 13030-13033. 

Barak, L. S., Oakley, R. H., Laporte, S. A., and Caron, M. G. (2001) Constitutive arrestin-mediated desensitization of a human vasopressin receptor mutant associated with nephrogenic diabetes insipidus. Proc. Natl. Acad. Sci. U. S. A. 98, 93-98. 

Water. Water resorption in the proximal tubule is a passive process in which water follows the osmotically active particles, particularly the Na" ions. Fine regulation of water excretion (diuresis) takes place in the collecting ducts, where the peptide hormone vasopressin (antidiuretic hormone, ADH) operates. This promotes recovery of water by stimulating the transfer of aquaporins (see p. 220) into the plasma membrane of the tubule cells via V2 receptors. A lack of ADH leads to the disease picture of diabetes insipidus, in which up to 30 L of final urine is produced per day. 

Acquired nephrogenic diabetes insipidus Acquired nephrogenic diabetes insipidus unresponsive to vasopressin has been associated with chronic lithium... 

A second form of diabetes is also recognized diabetes insipidus, which is caused by a deficiency of the pituitary hormone, vasopressin. Vasopressin promotes water reabsorption from the kidney, hence a deficiency also induces S5anptoms of excessive urination and thirst. A key diagnostic difference between the common diabetes meUitus and the rare diabetes insipidus, is the absence of glucose in the urine in the latter case. Until a few decades ago, a popular way to differentiate between the two diseases was to taste the patient s urine to see if it was sweet. 

VLc. Diabetes Insipidus and Vasopressin (Anti-diuretic Hormone)... 

Deficiency of pituitary vasopressin (arginine vasopressin or AVP, also termed anti-diuretic hormone, ADH) causes the syndrome of polyuria, thirst and polydipsia termed cranial diabetes insipidus. It is... 

Nephrogenic diabetes insipidus is due to resistance to action of vasopressin, and therefore DDAVP is not indicated, but some benefit may be gained by using thiazide diuretics or chlorpropamide. The syndrome of inappropriate antidiuretic hormone (SIADH) can be treated by using the antibiotic derivative demeclocycline to induce a state of vasopressin resistance and partial nephrogenic diabetes insipidus. 

For diabetes insipidus, vasopressin solution for injection maybe administered in-tranasallyon cotton pledgets, by nasal spray, orby dropper dose must be individualized... 

ADH in larger dose increases the blood pressure by direct stimulation of vascular smooth muscle. It also stimulates the smooth muscle of gastrointestinal tract and increase the peristalsis. It is inactive orally because it is destroyed by trypsin. It can be administered by any parenteral route or by nasal spray. Vasopressin is indicated in diabetes insipidus and in treatment of postoperative abdominal varices. 

Desmopressin Acetate (DDAVP) Chemically synthesized analogue of arginine vasopressin Treatment of diabetes insipidus... 

Vasopressin and desmopressin are used in the treatment of central diabetes insipidus. They are discussed in Chapter 37. Their renal action appears to be mediated primarily via V2 receptors although Vla receptors may also be involved. 

Polydipsia and polyuria are common but reversible concomitants of lithium treatment, occurring at therapeutic serum concentrations. The principal physiologic lesion involved is loss of responsiveness to antidiuretic hormone (nephrogenic diabetes insipidus). Lithium-induced diabetes insipidus is resistant to vasopressin but responds to amiloride. 

Vasopressin and desmopressin are treatments of choice for pituitary diabetes insipidus. The dosage of desmopressin is 10-40 meg (0.1-0.4 mL) in two to three divided doses as a nasal spray or, as an oral tablet, 0.1-0.2 mg two to three times daily. The dosage by injection is 1-4 meg (0.25-1 mL) every 12-24 hours as needed for polyuria, polydipsia, or hypernatremia. Bedtime desmopressin therapy, by intranasal or oral administration, ameliorates nocturnal enuresis by decreasing nocturnal urine production. Vasopressin infusion is effective in some cases of esophageal variceal bleeding and colonic diverticular bleeding. 

Desmopressin Activates vasopressin V2 receptors much more than Vi Acts in the kidney to decrease the excretion of water acts on extrarenal V2 receptors Pituitary diabetes insipidus hemophilia A and von Willebrand disease Oral, IV, SC, or intranasal Toxicity Gastrointestinal disturbances, headache, hyponatremia, allergic... 

Vasopressin Available for treatment of diabetes insipidus and sometimes used to control bleeding from esophageal varices ... 

Other aquaporins with related sequences occur broadly. There are at least ten in mammals.359,3593 Plants, which must accommodate to heavy loss of water in hot dry weather, have aquaporins in both plasma membranes and tonoplasts.360 Bacteria also have aquaporins.356,361 A defect in aquaporin-2 of the kidney collecting duct leads to nephrogenic diabetes insipidus, in which the kidneys fail to concentrate urine in response to secretion of the hormone vasopressin.3553 362,363... 

G-protein-coupled receptors.79 A defect in the type 2 vasopressin receptor leads to the condition of nephrogenic diabetes insipidus in which the body fails to concentrate the urine.77 80 Oxytocin acts on smooth muscles of the uterus during childbirth and triggers the release of milk from the mammary glands.81 The latter response is partially controlled by the suckling of the infant, which induces the nervous system to release oxytocin into the bloodstream. 

Desmopressin f/V-deamino-8-D-arginine vasopressin, dDAVP) is a longer acting analogue of vasopressin. It has very little vasoactive effect but is antidiuretic by an action on vasopressin V2 receptors in the renal tubule and is used to treat central diabetes insipidus and nocturnal enuresis. 

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