Vasopressin: Mechanisms of Action, Physiology and Side Effects : Mechanisms of Action, Physiology and Side Effects [1 ed.] 9781624173127, 9781624173110

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Copyright © 2013. Nova Science Publishers, Incorporated. All rights reserved. Vasopressin: Mechanisms of Action, Physiology and Side Effects : Mechanisms of Action, Physiology and Side Effects, Nova

Copyright © 2013. Nova Science Publishers, Incorporated. All rights reserved. Vasopressin: Mechanisms of Action, Physiology and Side Effects : Mechanisms of Action, Physiology and Side Effects,

NEUROSCIENCE RESEARCH PROGRESS

VASOPRESSIN

Copyright © 2013. Nova Science Publishers, Incorporated. All rights reserved.

MECHANISMS OF ACTION, PHYSIOLOGY AND SIDE EFFECTS

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Vasopressin: Mechanisms of Action, Physiology and Side Effects : Mechanisms of Action, Physiology and Side Effects,

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Vasopressin: Mechanisms of Action, Physiology and Side Effects : Mechanisms of Action, Physiology and Side Effects,

NEUROSCIENCE RESEARCH PROGRESS

VASOPRESSIN

Copyright © 2013. Nova Science Publishers, Incorporated. All rights reserved.

MECHANISMS OF ACTION, PHYSIOLOGY AND SIDE EFFECTS

LEONZIO GALELLA EDITOR

New York

Vasopressin: Mechanisms of Action, Physiology and Side Effects : Mechanisms of Action, Physiology and Side Effects,

Copyright © 2013 by Nova Science Publishers, Inc. All rights reserved. No part of this book may be reproduced, stored in a retrieval system or transmitted in any form or by any means: electronic, electrostatic, magnetic, tape, mechanical photocopying, recording or otherwise without the written permission of the Publisher. For permission to use material from this book please contact us: Telephone 631-231-7269; Fax 631-231-8175 Web Site: http://www.novapublishers.com

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The Publisher has taken reasonable care in the preparation of this book, but makes no expressed or implied warranty of any kind and assumes no responsibility for any errors or omissions. No liability is assumed for incidental or consequential damages in connection with or arising out of information contained in this book. The Publisher shall not be liable for any special, consequential, or exemplary damages resulting, in whole or in part, from the readers’ use of, or reliance upon, this material. Any parts of this book based on government reports are so indicated and copyright is claimed for those parts to the extent applicable to compilations of such works. Independent verification should be sought for any data, advice or recommendations contained in this book. In addition, no responsibility is assumed by the publisher for any injury and/or damage to persons or property arising from any methods, products, instructions, ideas or otherwise contained in this publication. This publication is designed to provide accurate and authoritative information with regard to the subject matter covered herein. It is sold with the clear understanding that the Publisher is not engaged in rendering legal or any other professional services. If legal or any other expert assistance is required, the services of a competent person should be sought. FROM A DECLARATION OF PARTICIPANTS JOINTLY ADOPTED BY A COMMITTEE OF THE AMERICAN BAR ASSOCIATION AND A COMMITTEE OF PUBLISHERS. Additional color graphics may be available in the e-book version of this book.

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Vasopressin: Mechanisms of Action, Physiology and Side Effects : Mechanisms of Action, Physiology and Side Effects,

CONTENTS Preface

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Chapter 1

vii An Unfairly Undervalued Participant of the Stress Processes: The Vasopressin János Varga and Dóra Zelena

Chapter 2

Vasopressin in Pediatric Shock Karen Choong

Chapter 3

The Therapeutic Potential and the Challenges of Modulating Myometrial Smooth Muscle Tone through the Vasopressin V1A Receptor Nick Pullen

Chapter 4

Chapter 5

The Efficacy of Vasoactive Medications in Acute Variceal Bleeds Malcolm Wells, Nilesh Chande and Melanie Beaton Reproductive and Metabolic Responses of Desert Adapted Common Spiny Male Mice (Acomys Cahirinus) to Vasopressin Treatment Elena Bukovetzky, Fuad Fares, Hagit Schwimmer and Abraham Haim

Index

Vasopressin: Mechanisms of Action, Physiology and Side Effects : Mechanisms of Action, Physiology and Side Effects,

1 29

55

75

91

107

Copyright © 2013. Nova Science Publishers, Incorporated. All rights reserved. Vasopressin: Mechanisms of Action, Physiology and Side Effects : Mechanisms of Action, Physiology and Side Effects,

Copyright © 2013. Nova Science Publishers, Incorporated. All rights reserved.

PREFACE Vasopressin is a hormone involved in water balance and osmoregulation. It is produced by the hypothalamus and released by the neuro-pituitary. In this book, the authors discuss the mechanisms of action, physiology and side effects of vasopressin. Topics include the study of the role of vasopressin in hypothalamo-pituitary-adrenocortical (HPA) axis regulation; vasopressin used in both adult and pediatric vasodilatory shock and cardiac arrest; the therapeutic potential and challenges of modulating myometrial smooth muscle tone through the vasopressin V1A receptor; the efficacy of vasoactive medications in acute variceal bleeds; and the reproductive and metabolic responses of desert adapted common spiny male mice to vasopressin treatment. Chapter 1 – The authors environment can be considered as a set of stressors. Adaptation to them is indispensable to life. However, overloading the hypothalamo-pituitary-adrenocortical (HPA) axis, one of the major components of adaptation, often leads to stress-related diseases. Therefore understanding the mechanisms of stress processes is highly important. The hypothalamic component of the HPA axis consists of corticotropin-releasing hormone (CRH) and vasopressin, with a questionable contribution of the latter. The natural vasopressin knockout Brattleboro strain is a good tool for the stress-free study of the role of vasopressin in HPA axis regulation. Data from this strain was compared to knockout mice, vasopressin-antiserum and V1b receptor antagonist studies. In adult Brattleboro rats the vasopressin-deficiency did not influence the resting levels as well as the development of chronic stress state. However, the CRH-supporting effect of vasopressin was observable after different acute stress situations, where the exact role depended on the nature of the stressor encountered. In contrast, vasopressin had more crucial role in the

Vasopressin: Mechanisms of Action, Physiology and Side Effects : Mechanisms of Action, Physiology and Side Effects,

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v Leonzio Galella ii i regulation of the adrenocorticotropin (ACTH, the hypophyseal level of the HPA axis) secretion during the perinatal age, which was observable during a wide range of relevant physiological stress processes. The dissociation between ACTH and corticosterone secretion (the next, adrenal level of the HPA axis) was surprising. The vasopressin deficiency resulted in higher corticosterone levels than expected based on the low stressor-induced ACTH secretion, therefore an ACTH-independent adrenal gland regulation can be assumed. There was no obvious difference in the HPA axis regulatory role of vasopressin between the two genders. The authors can conclude that vasopressin plays a more important role in the stress-axis regulation during early development, than we previously thought. Chapter 2 – Vasopressin has been used in both adult and pediatric vasodilatory shock and cardiac arrest. The evidence in this area is primarily adult based, while pediatric specific data is more limited. The rationale for vasopressin in shock is based on the following: 1) it reverses the key mechanisms responsible for pathologic vasodilatation and catecholamine resistance, 2) despite its potent systemic vasoconstrictor properties, vasopressin has concurrent organ-specific vasodilator effects that may result in preserved vital organ perfusion; 3) vasopressin influences multiple other hormone responses which may modulate hypothalamic-pituitary axis dysfunction and cellular immune response during septic shock; and 4) vasopressin insufficiency, and an increased sensitivity to the pressor effects of exogenous vasopressin has been demonstrated in both adults and perhaps children with septic shock. There are to date a total of 40 published pediatric studies evaluating the use of vasopressin in shock, reporting on a collective total of only 642 children. 35 of these studies are in shock, and 5 studies are in cardiac arrest. The vast majority of studies are case reports or case series. Only 2 of these studies are randomized controlled trials (RCT) – one of which was a multicentred, double-blind RCT of arginine vasopressin in 69 patients vasodilatory shock, while the other was an open-label 58 patient RCT of terlipressin in catecholamine-resistant septic shock While there may be some evidence of short-term benefits with no increased risk of adverse effects, there has been no demonstrable superiority of vasopressin over traditional vasoactive agents on patient important outcomes such as survival, in children with catecholaminerefractory shock and cardiopulmonary arrest. As a result, vasopressin is not currently recommended as a first line vasoactive agent in pediatric patients with hemodynamic instability. The mortality rate amongst children with shock remains unacceptably high, ranging from 15-70%. As a result, these

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Preface

ix

challenges and controversies rationalize the importance of ongoing prospective research on a potential role for vasopressin in the setting of pediatric shock. Chapter 3 – Arginine vasopressin plays a key role in the regulation of diverse physiological processes in the cardiovascular, renal, uterine and CNS systems. Abnormal release or activation of vasopressin receptors appears to contribute to the disease pathogenesis and physiology of a number of conditions including polycystic kidney disease, congestive heart failure, septic shock and depression, especially. In recent years, both improved biophysical techniques as well as the discovery of potent and selective vasopressin ligands have helped facilitate a better understanding of the critical receptors involved in these disease processes. The authors will outline the role of vasopressin in the regulation of normal myometrial smooth muscle contraction during menstruation and parturition as well as the consequences of inappropriate activation leading to dysmenorrhoea and early labour. Chapter 4 – Vasoactive medications such as vasopressin, somatostatin and their analogues are commonly used for the treatment of acute variceal bleeding. Vasoactive medications have been used for over thirty years and management has improved with better endoscopic therapies and the use of antibiotics prophylactically. Even with such a long history, the risks and benefits of the use of vasoactive medications continue to be debated. In this article the authors explore the evidence behind the efficacy of these medications. Chapter 5 – Changes in day length (photoperiod) can serve as an important signal for the coming breeding season for mammals inhabiting predictable ecosystems in temperate zones. In unpredictable desert ecosystems, photoperiod changes are not a sufficient signal to predict the optimal time of breeding. Therefore, integration of various environmental cues should determine which species will be adapted to breed at the right time and to survive in xeric environments. In regards the authors asked the following question: What are the environmental cues and their mechanism used by xeric adapted small mammals for reproduction timing? The driving force in desert ecosystems is water and the intervals between episodes of water input into the ecosystem vary and in some years there may be no input. It has been suggested that water availability can serve as a reliable cue for reproduction. Vasopressin (VP), a hormone involved in water balance and osmoregulation is produced by the hypothalamus and released by the neuropituitary. VP secretion levels increase in response to elevated plasma osmolarity, representing water shortage. VP receptors are found in the

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x

Leonzio Galella

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reproductive tract. The different effects of VP on metabolism and reproduction make it candidate for mediating the transmission of environmental signals to the reproductive system of desert adapted rodents. The authors tested the metabolic and reproductive response of males from a desert adapted population of A. cahirinus to VP treatment under three week acclimation to two different photoperiod regimes short (SD- 8L:16D) and long (LD16L:8D). The results of the authors study show that VP treatment per se, caused a significant (p