Vasopressin : Disturbed Secretion and Its Effects

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The mechanisms by which animals regulate the volume and composition of their body fluids has long had a particular fascination for students of biology. As a consequence, the subject can lay claim to an impressive record of ground- breaking scientific achievements as well as a provocative body of philosophical speculation concerning the role of the system in the origin and evolution of life. Indeed, the entire concept of homeostasis on which so much of o~r current biologic thinking is based, derives from Claude Bernard's pioneering exploration of the forces that determine the composition of this 'internal sea'. Other seminal achievements credited to this area of inquiry include the first description of a genetically transmitted human disease (familial neurogenic diabetes insipidus); the first isolation sequencing and synthesis of a peptide hormone (vasopressin and oxytocin); the first demonstration of peptide hormone synthesis by way of a larger protein precursor; the first description of resistance to the biologic actions of a hormone (nephrogenic diabetes insipidus); and the conceptual realization of the unique counter-current mechanism that permits concentration of the urine. This record of far reaching and fundamental advances has been distinguished by many fruitful inter- actions between clinical and basic science.
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Product details

  • Hardback | 296 pages
  • Dordrecht, Netherlands
  • English
  • 1989 ed.
  • XIV, 296 p.
  • 0792302494
  • 9780792302490

Table of contents

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.
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