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{{Uporabnikov peskovnik}}
'''Vazopresin''' ali '''antidiuretični hormon''' ('''ADH'''), pa tudi '''antidiuretski hormon''' in '''adiuretin''', je [[Nevrohipofiza|nevrohipofizni]] [[hormon]], ki se sintetizira v [[Hipotalamus|hipotalamusu]], služi pa večanju prepustnosti [[Zbiralce|zbiralc]] in daljnih [[Ledvična cevka|cevčic]] (distalnih tubulov) za vodo. Na organizem deluje antidiuretično (zmanjšuje [[Diureza|diurezo]]) in [[Vazokonstrikcija|vazokonstriktorno]] (krči [[Krvna žila|žile]] ter s tem viša [[krvni tlak]]). Kemično je vazopresin [[Ciklična spojina|ciklični]] [[Peptid|nonapeptid]].<ref name=":0">{{Navedi splet|title=Termania - Slovenski medicinski slovar - vazopresín|url=https://www.termania.net/slovarji/slovenski-medicinski-slovar/5543585/vazopresin?ld=95&query=vazopresin&SearchIn=Linked|website=www.termania.net|accessdate=2021-06-22}}</ref> Ker ima adiuretin pri človeku in večjem deležu preostalih [[Sesalci|sesalcev]] na osmem mestu [[Aminokislina|aminokislino]] [[arginin]], mu pravimo tudi '''arginin-vazopresin''' ('''AVP''') in '''argipresin'''.<ref name=":0" /><ref>{{Navedi splet|title=Termania - Slovenski medicinski slovar - arginín-vazopresín|url=https://www.termania.net/slovarji/slovenski-medicinski-slovar/5506736/arginin-vazopresin?ld=95&query=arginin-vazopresin&SearchIn=Linked|website=www.termania.net|accessdate=2021-06-22}}</ref>
Vazopresin je hormon, ki nastaja po [[Nukleotid|nukleotidnem]] zaporedju [[Gen AVP|gena AVP]] v [[Nevron|nevronih]] (živčnih celicah) hipotalamusa. Produkt prepisovanja ([[transkripcije]]) in prevajanja ([[Translacija|translacije]]) gena AVP je peptidni prohormon, ki se nato pretvori v AVP (aginin-vazopresin). Ta zatem potuje vzdolž [[Akson|aksonov]] živčnih celic, ki prehajajo v zadnji reženj hipofize, tako imenovano nevrohipofizo, kjer se hormon sprošča v [[obtočila]] (preko [[Vezikel|veziklov]], prenos poganja [[Hipertonična raztopina|hipertonična]] zunajcelična tekočina).<ref name="Marieb">{{cite book | vauthors = Marieb E | title = Anatomy & physiology | publisher = Pearson Education, Inc | location = Glenview, IL | year = 2014 | isbn = 978-0-321-86158-0 }}</ref><ref name="isbn0-387-30348-0">{{cite book | vauthors = Caldwell HK, ((Young WS III)) | veditors = Lajtha A, Lim R | title = Handbook of Neurochemistry and Molecular Neurobiology: Neuroactive Proteins and Peptides | edition = 3rd | publisher = Springer | location = Berlin | year = 2006 | chapter = Oxytocin and Vasopressin: Genetics and Behavioral Implications | chapter-url= http://refworks.springer.com/mrw/fileadmin/pdf/Neurochemistry/0387303480C25.PDF | pages = 573–607| isbn = 978-0-387-30348-2 }}</ref><ref name="babar2013">{{cite journal | vauthors = Babar SM | title = SIADH associated with ciprofloxacin | journal = The Annals of Pharmacotherapy | volume = 47 | issue = 10 | pages = 1359–63 | date = October 2013 | pmid = 24259701 | doi = 10.1177/1060028013502457 | s2cid = 36759747 }}</ref>
Antidiuretični hormon morda opravlja še eno pomembno vlogo, saj se v manjših količinah sprošča iz hipotalamusa v [[Možgani|možgane]], kjer naj bi imel funkcijo v socialnem vedenju, privlačnosti med partnerjema in materinskih odzivih na stres.<ref>{{cite journal | vauthors = Insel TR | title = The challenge of translation in social neuroscience: a review of oxytocin, vasopressin, and affiliative behavior | language = en | journal = Neuron | volume = 65 | issue = 6 | pages = 768–79 | date = March 2010 | pmid = 20346754 | pmc = 2847497 | doi = 10.1016/j.neuron.2010.03.005 }}</ref> Vazopresin vzpodbuja [[Diferenciacija|diferenciacijo]] matičnih celic v [[Kardiomiocit|kardiomiocite]] (srčno-mišične celice) in [[Homeostaza|homeostazo]] [[Srčna mišičnina|srčne mišice]].<ref name="Costa_2014">{{cite journal | vauthors = Costa A, Rossi E, Scicchitano BM, Coletti D, Moresi V, Adamo S | title = Neurohypophyseal Hormones: Novel Actors of Striated Muscle Development and Homeostasis | journal = European Journal of Translational Myology | volume = 24 | issue = 3 | pages = 3790 | date = September 2014 | pmid = 26913138 | pmc = 4756744 | doi = 10.4081/bam.2014.3.217| department = review }}</ref>
Ima precej kratko razpolovno dobo, zgolj 16–24 minut.<ref name="babar2013" />
{{TOC limit|3}}
==Physiology==
===Function===
Vasopressin regulates the [[tonicity]] of body fluids. It is released from the posterior pituitary in response to [[hypertonicity]] and causes the kidneys to reabsorb solute-free water and return it to the circulation from the tubules of the nephron, thus returning the tonicity of the body fluids toward normal. An incidental consequence of this renal reabsorption of water is concentrated [[urine]] and reduced urine volume. AVP released in high concentrations may also raise blood pressure by inducing moderate [[vasoconstriction]].
AVP also may have a variety of neurological effects on the brain. It may influence pair-bonding in [[voles]]. The high-density distributions of vasopressin receptor AVPr1a in [[prairie vole]] ventral forebrain regions have been shown to facilitate and coordinate reward circuits during partner preference formation, critical for pair bond formation.<ref name="Young2004">{{cite journal | vauthors = Lim MM, Young LJ | title = Vasopressin-dependent neural circuits underlying pair bond formation in the monogamous prairie vole | journal = Neuroscience | volume = 125 | issue = 1 | pages = 35–45 | year = 2004 | pmid = 15051143 | doi = 10.1016/j.neuroscience.2003.12.008 | s2cid = 16210017 }}</ref>
A very similar substance, ''lysine vasopressin'' ('''LVP''') or '''lypressin''', has the same function in [[pig]]s and its synthetic version was used in human AVP deficiency, although it has been largely replaced by [[desmopressin]].<ref>{{Cite web|vauthors = Chapman IM, ((Professor of Medicine, Discipline of Medicine, University of Adelaide, Royal Adelaide Hospital))|url=http://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/pituitary-disorders/central-diabetes-insipidus#v26379947|title=Central Diabetes Insipidus|website=MSD|publisher= Merck & Co. Inc.}}</ref>
==
Vasopressin has three main effects which are:
# Increasing the water permeability of distal and cortical collecting tubules (PCT & CCT), as well as outer and inner medullary collecting duct (OMCD & IMCD) in the kidney, thus allowing water reabsorption and excretion of more concentrated urine, i.e., [[antidiuretic|antidiuresis]]. This occurs through increased transcription and insertion of water channels ([[aquaporin|Aquaporin-2]]) into the [[apical membrane]] of collecting tubule and collecting duct epithelial cells.<ref>{{cite book | title = Medical Physiology | vauthors = Boron WR, Boulpaep EL | isbn = 978-1-4557-4377-3 | edition = Third | location = Philadelphia, PA | oclc = 951680737 |date = 2016-05-05}}</ref> Aquaporins allow water to move down their osmotic gradient and out of the nephron, increasing the amount of water re-absorbed from the filtrate (forming urine) back into the bloodstream. This effect is mediated by [[V2 receptor]]s. Vasopressin also increases the concentration of calcium in the collecting duct cells, by episodic release from intracellular stores. Vasopressin, acting through cAMP, also increases transcription of the aquaporin-2 gene, thus increasing the total number of aquaporin-2 molecules in collecting duct cells.<ref>{{cite journal | vauthors = Wilson JL, Miranda CA, Knepper MA| title = Vasopressin and the Regulation of Aquaporin-2 | journal = Clinical and Experimental Nephrology | year = 2013 | volume = 17 | issue = 6 | pages = 10.1007/s10157-013-0789-5 | doi = 10.1007/s10157-013-0789-5 | pmid = 23584881 | pmc = 3775849 }}</ref>
# Increasing permeability of the inner medullary portion of the collecting duct to [[urea]] by regulating the cell surface expression of [[urea transporter]]s,<ref name="pmid21686211">{{cite journal | vauthors = Sands JM, Blount MA, Klein JD | title = Regulation of renal urea transport by vasopressin | journal = Transactions of the American Clinical and Climatological Association | volume = 122 | pages = 82–92 | year = 2011 | pmid = 21686211 | pmc = 3116377 }}</ref> which facilitates its reabsorption into the [[medullary interstitium]] as it travels down the concentration gradient created by removing water from the [[connecting tubule]], [[cortical collecting duct]], and [[outer medullary collecting duct]].
# Acute increase of [[sodium]] absorption across the ascending [[loop of Henle]]. This adds to the [[countercurrent multiplication]] which aids in proper water reabsorption later in the [[distal tubule]] and [[collecting duct]].<ref name="pmid10073614">{{cite journal | vauthors = Knepper MA, Kim GH, Fernández-Llama P, Ecelbarger CA | title = Regulation of thick ascending limb transport by vasopressin | journal = Journal of the American Society of Nephrology | volume = 10 | issue = 3 | pages = 628–34 | date = March 1999 | doi = 10.1681/ASN.V103628 | pmid = 10073614 | doi-access = free }}</ref>
====Central nervous system====
Vasopressin released within the brain may have several actions:
* Vasopressin is released into the brain in a [[circadian rhythm]] by neurons of the [[suprachiasmatic nucleus]].<ref>{{cite journal | vauthors = Forsling ML, Montgomery H, Halpin D, Windle RJ, Treacher DF | title = Daily patterns of secretion of neurohypophysial hormones in man: effect of age | journal = Experimental Physiology | volume = 83 | issue = 3 | pages = 409–18 | date = May 1998 | pmid = 9639350 | doi = 10.1113/expphysiol.1998.sp004124 | s2cid = 2295415 | doi-access = free }}</ref>
* Vasopressin released from posterior pituitary is associated with nausea.<ref name=newrev2017>{{cite journal | vauthors = Magtanong E | title = What Is Nausea? A Historical Analysis of Changing Views | journal = Auton Neurosci| year = 2017| volume = 202 | pages = 5–17 | doi = 10.1016/j.autneu.2016.07.003 | pmid = 27450627| pmc = 5203950 }}</ref>
*Recent evidence suggests that vasopressin may have analgesic effects. The analgesia effects of vasopressin were found to be dependent on both stress and sex.<ref name="pmid22119947">{{cite journal | vauthors = Wiltshire T, Maixner W, Diatchenko L | title = Relax, you won't feel the pain | journal = Nature Neuroscience | volume = 14 | issue = 12 | pages = 1496–7 | date = December 2011 | pmid = 22119947 | doi = 10.1038/nn.2987 | s2cid = 205434100 }}</ref>
===Regulation===
<!--The pituitary gland releases vasopressin [[posterior pituitary gland|gland]]<nowiki/>in response to reductions in [[blood plasma|plasma]] voes in the [[plasma osmolality]], and in response to [[cholecystokinin]] (CCK) secreted by the [[small intestine]]:
* Secretion ''in response to reduced plasma volume'' is activated by [[baroreceptor|pressure receptors]] (baroreceptors) in the [[vein]]s, [[atrium (anatomy)|atria]], and [[carotid sinus]]es.{{citation needed|date=February 2016}}
* Secretion ''in response to increases in plasma osmotic pressure'' is mediated by [[osmoreceptor]]s in the [[hypothalamus]].{{citation needed|date=February 2016}}
* Secretion ''in response to increases in plasma CCK'' is mediated by an unknown pathway.{{citation needed|date=February 2016}}
The neurons that make AVP, in the hypothalamic [[supraoptic nucleus|supraoptic nuclei]] (SON) and [[paraventricular nucleus|paraventricular nuclei]] (PVN), are themselves osmoreceptors, but they also receive synaptic input from other osmoreceptors located in regions adjacent to the anterior wall of the third ventricle. These regions include the [[organum vasculosum of the lamina terminalis]] and the [[subfornical organ]].{{cn}}-->
==== Gene regulation ====
{{Further|AVP gene}}
Vasopressin is regulated by [[AVP gene]] expression which is managed by major clock controlled genes. In this circadian circuit known as the [[Transcription translation feedback loop|transcription-translation feedback loop]] (TTFL), [[PER2|Per2]] protein accumulates and is phosphorylated by [[Casein kinase 1 isoform epsilon|CK1E]]. Per2 subsequently inhibits the transcription factors [[CLOCK|Clock]] and [[BMAL1]] in order to reduce Per2 protein levels in the cell.<ref>{{cite journal | vauthors = Dunlap JC | title = Molecular bases for circadian clocks | journal = Cell | volume = 96 | issue = 2 | pages = 271–90 | date = January 1999 | pmid = 9988221 | doi = 10.1016/s0092-8674(00)80566-8 | s2cid = 14991100 }}</ref> At the same time, Per2 also inhibits the transcription factors for the AVP gene in order to regulate its expression, the expression of vasopressin, and other AVP gene products.<ref>{{cite journal | vauthors = Jin X, Shearman LP, Weaver DR, Zylka MJ, de Vries GJ, Reppert SM | title = A molecular mechanism regulating rhythmic output from the suprachiasmatic circadian clock | journal = Cell | volume = 96 | issue = 1 | pages = 57–68 | date = January 1999 | pmid = 9989497 | doi = 10.1016/s0092-8674(00)80959-9 | s2cid = 6916996 }}</ref>
Many factors influence the secretion of vasopressin:
* [[Ethanol]] (alcohol) reduces the calcium-dependent secretion of AVP by blocking voltage-gated calcium channels in neurohypophyseal nerve terminals in rats.<ref>{{cite journal | vauthors = Wang XM, Dayanithi G, Lemos JR, Nordmann JJ, Treistman SN | title = Calcium currents and peptide release from neurohypophysial terminals are inhibited by ethanol | journal = The Journal of Pharmacology and Experimental Therapeutics | volume = 259 | issue = 2 | pages = 705–11 | date = November 1991 | pmid = 1941619 }}</ref>
* [[Angiotensin]] II stimulates AVP secretion, in keeping with its general pressor and pro-volumic effects on the body.<ref name="Matsukawa">{{cite journal | vauthors = Matsukawa T, Miyamoto T | title = Angiotensin II-stimulated secretion of arginine vasopressin is inhibited by atrial natriuretic peptide in humans | journal = American Journal of Physiology. Regulatory, Integrative and Comparative Physiology | volume = 300 | issue = 3 | pages = R624–9 | date = March 2011 | pmid = 21123762 | doi = 10.1152/ajpregu.00324.2010 }}</ref>
*[[Atrial natriuretic peptide]] inhibits AVP secretion, in part by inhibiting Angiotensin II-induced stimulation of AVP secretion.<ref name="Matsukawa"/>
*[[Cortisol]] inhibits secretion of antidiuretic hormone.<ref>{{cite book|author=Collège des enseignants d'endocrinologie, diabète et maladie|title=Endocrinologie, diabétologie et maladies métaboliques|date=2012-01-30|publisher=Elsevier Masson|isbn=978-2-294-72233-2}}</ref>
===Production and secretion===
The physiologic stimulus for secretion of vasopressin is increased osmolality of the plasma, monitored by the hypothalamus. A decreased arterial [[blood volume]], (such as can occur in [[cirrhosis]], [[nephrosis]] and [[heart failure]]), stimulates secretion, even in the face of decreased osmolality of the plasma: it supersedes osmolality, but
with a milder effect. In other words, vasopressin is secreted in spite of the presence of hypoosmolality (hyponatremia) when the arterial blood volume is low.
The AVP that is measured in peripheral blood is almost all derived from secretion from the [[posterior pituitary gland]] (except in cases of AVP-secreting tumours). Vasopressin is produced by [[magnocellular neurosecretory neuron]]s in the [[paraventricular nucleus of hypothalamus]] (PVN) and [[supraoptic nucleus]] (SON). It then travels down the axon through the [[Pituitary stalk|infundibulum]] within neurosecretory granules that are found within Herring bodies, localized swellings of the axons and nerve terminals. These carry the peptide directly to the posterior pituitary gland, where it is stored until released into the blood.
There are other sources of AVP, beyond the hypothalamic magnocellular neurons. For example, AVP is also synthesized by [[Parvocellular neurosecretory cell|parvocellular neurosecretory neurons]] of the PVN, transported and released at the [[median eminence]], from which it travels through the [[hypophyseal portal system]] to the anterior pituitary, where it stimulates [[corticotropic cell]]s synergistically with CRH to produce ACTH (by itself it is a weak secretagogue).<ref name="pmid2830315">{{cite journal | vauthors = Salata RA, Jarrett DB, Verbalis JG, Robinson AG | title = Vasopressin stimulation of adrenocorticotropin hormone (ACTH) in humans. In vivo bioassay of corticotropin-releasing factor (CRF) which provides evidence for CRF mediation of the diurnal rhythm of ACTH | journal = The Journal of Clinical Investigation | volume = 81 | issue = 3 | pages = 766–74 | date = March 1988 | pmid = 2830315 | pmc = 442524 | doi = 10.1172/JCI113382 }}</ref>
=== Vasopressin during surgery and anaesthesia ===
Vasopressin concentration is used to measure [[surgical stress]] for evaluation of surgical techniques. Plasma vasopressin concentration is elevated by [[noxious stimuli]],<ref>{{cite journal | vauthors = Day TA, Sibbald JR | title = Noxious somatic stimuli excite neurosecretory vasopressin cells via A1 cell group | journal = The American Journal of Physiology | volume = 258 | issue = 6 Pt 2 | pages = R1516-20 | date = June 1990 | pmid = 2360697 | doi = 10.1152/ajpregu.1990.258.6.R1516 }}</ref><ref>{{cite journal | vauthors = Höglund OV, Hagman R, Olsson K, Olsson U, Lagerstedt AS | title = Intraoperative changes in blood pressure, heart rate, plasma vasopressin, and urinary noradrenalin during elective ovariohysterectomy in dogs: repeatability at removal of the 1st and 2nd ovary | journal = Veterinary Surgery | volume = 43 | issue = 7 | pages = 852–9 | date = October 2014 | pmid = 25130060 | doi = 10.1111/j.1532-950X.2014.12264.x }}</ref> predominantly during abdominal surgery,<ref>{{cite journal | vauthors = Goldmann A, Hoehne C, Fritz GA, Unger J, Ahlers O, Nachtigall I, Boemke W | title = Combined vs. Isoflurane/Fentanyl anesthesia for major abdominal surgery: Effects on hormones and hemodynamics | journal = Medical Science Monitor | volume = 14 | issue = 9 | pages = CR445-52 | date = September 2008 | pmid = 18758414 }}</ref><ref>{{cite journal | vauthors = Furuya K, Shimizu R, Hirabayashi Y, Ishii R, Fukuda H | title = Stress hormone responses to major intra-abdominal surgery during and immediately after sevoflurane-nitrous oxide anaesthesia in elderly patients | journal = Canadian Journal of Anaesthesia | volume = 40 | issue = 5 Pt 1 | pages = 435–9 | date = May 1993 | pmid = 8390330 | doi = 10.1007/BF03009513 | doi-access = free }}</ref><ref>{{cite journal | vauthors = Haas M, Glick SM | title = Radioimmunoassayable plasma vasopressin associated with surgery | journal = Archives of Surgery | volume = 113 | issue = 5 | pages = 597–600 | date = May 1978 | pmid = 646620 | doi = 10.1001/archsurg.1978.01370170059011 }}</ref> especially at gut manipulation and traction of viscera.<ref>{{cite journal | vauthors = Nussey SS, Page SR, Ang VT, Jenkins JS | title = The response of plasma oxytocin to surgical stress | journal = Clinical Endocrinology | volume = 28 | issue = 3 | pages = 277–82 | date = March 1988 | pmid = 3168310 | doi = 10.1111/j.1365-2265.1988.tb01213.x | s2cid = 37668345 }}</ref><ref>{{cite journal | vauthors = Melville RJ, Forsling ML, Frizis HI, LeQuesne LP | title = Stimulus for vasopressin release during elective intra-abdominal operations | journal = The British Journal of Surgery | volume = 72 | issue = 12 | pages = 979–82 | date = December 1985 | pmid = 4084755 | doi = 10.1002/bjs.1800721215 | s2cid = 43764321 }}</ref><ref>{{cite journal | vauthors = Moran WH, Miltenberger FW, Shuayb WA, Zimmermann B | title = The Relationship of Antidiuretic Hormone Secretion to Surgical Stress | journal = Surgery | volume = 56 | pages = 99–108 | date = July 1964 | pmid = 14175989 }}</ref>
=== Receptors ===
Types of AVP receptors and their actions:
{| class="wikitable"
| '''Type''' || '''[[Second messenger system]] ''' || '''Locations''' || '''Actions'''
|'''Agonists'''
|'''Antagonists'''
|-
| [[Arginine vasopressin receptor 1A|AVPR1A]] || [[Phosphatidylinositol]]/[[calcium]] || [[Liver]], [[kidney]], peripheral vasculature, [[brain]] || [[Vasoconstriction]], [[gluconeogenesis]], [[platelet]] aggregation, and release of [[factor VIII]] and [[von Willebrand factor]]; social recognition,<ref name="pmid14647484">{{cite journal | vauthors = Bielsky IF, Hu SB, Szegda KL, Westphal H, Young LJ | title = Profound impairment in social recognition and reduction in anxiety-like behavior in vasopressin V1a receptor knockout mice | journal = Neuropsychopharmacology | volume = 29 | issue = 3 | pages = 483–93 | date = March 2004 | pmid = 14647484 | doi = 10.1038/sj.npp.1300360 | doi-access = free }}</ref> circadian tau<ref name="pmid17083331">{{cite journal | vauthors = Wersinger SR, Caldwell HK, Martinez L, Gold P, Hu SB, Young WS | title = Vasopressin 1a receptor knockout mice have a subtle olfactory deficit but normal aggression | journal = Genes, Brain, and Behavior | volume = 6 | issue = 6 | pages = 540–51 | date = August 2007 | pmid = 17083331 | doi = 10.1111/j.1601-183X.2006.00281.x | s2cid = 29923520 | doi-access = free }}</ref>
|[[Felypressin]]
|
|-
| [[Arginine vasopressin receptor 1B|AVPR1B or AVPR3]] || [[Phosphatidylinositol]]/[[calcium]] || [[Pituitary gland]], [[brain]] || [[Adrenocorticotropic hormone]] secretion in response to stress;<ref name="pmid17122081">{{cite journal | vauthors = Lolait SJ, Stewart LQ, Jessop DS, Young WS, O'Carroll AM | title = The hypothalamic-pituitary-adrenal axis response to stress in mice lacking functional vasopressin V1b receptors | journal = Endocrinology | volume = 148 | issue = 2 | pages = 849–56 | date = February 2007 | pmid = 17122081 | pmc = 2040022 | doi = 10.1210/en.2006-1309 }}</ref> social interpretation of olfactory cues<ref name="pmid15555506">{{cite journal | vauthors = Wersinger SR, Kelliher KR, Zufall F, Lolait SJ, O'Carroll AM, Young WS | title = Social motivation is reduced in vasopressin 1b receptor null mice despite normal performance in an olfactory discrimination task | journal = Hormones and Behavior | volume = 46 | issue = 5 | pages = 638–45 | date = December 2004 | pmid = 15555506 | doi = 10.1016/j.yhbeh.2004.07.004 | s2cid = 38444963 | url = https://zenodo.org/record/1259471 }}</ref>
|
|
|-
| [[Arginine vasopressin receptor 2|AVPR2]] || [[Adenylate cyclase]]/[[Cyclic adenosine monophosphate|cAMP]] || Basolateral membrane of the cells lining the [[collecting duct]]s of the kidneys (especially the cortical and outer medullary collecting ducts) || Insertion of [[aquaporin-2]] (AQP2) channels (water channels). This allows water to be reabsorbed down an osmotic gradient, and so the urine is more concentrated. Release of [[von Willebrand factor]] and surface expression of [[P-selectin]] through exocytosis of [[Weibel-Palade bodies]] from [[endothelial cells]]<ref name="pmid7545469">{{cite journal | vauthors = Kanwar S, Woodman RC, Poon MC, Murohara T, Lefer AM, Davenpeck KL, Kubes P | title = Desmopressin induces endothelial P-selectin expression and leukocyte rolling in postcapillary venules | journal = Blood | volume = 86 | issue = 7 | pages = 2760–6 | date = October 1995 | doi = 10.1182/blood.V86.7.2760.2760 | pmid = 7545469 | url = http://bloodjournal.hematologylibrary.org/cgi/reprint/86/7/2760 | doi-access = free }}</ref><ref name="pmid10880054">{{cite journal | vauthors = Kaufmann JE, Oksche A, Wollheim CB, Günther G, Rosenthal W, Vischer UM | title = Vasopressin-induced von Willebrand factor secretion from endothelial cells involves V2 receptors and cAMP | journal = The Journal of Clinical Investigation | volume = 106 | issue = 1 | pages = 107–16 | date = July 2000 | pmid = 10880054 | pmc = 314363 | doi = 10.1172/JCI9516 }}</ref>
|AVP, [[desmopressin]]
|"-vaptan" diuretics, i.e. [[tolvaptan]]
|}
===Structure and relation to oxytocin===
[[File:vasopressin labeled.png|thumb|right|Chemical structure of the arginine vasopressin (argipressin) with an [[arginine]] at the 8th [[amino acid]] position. Lysine vasopressin differs only in having a [[lysine]] in this position.]]
[[File:Oxytocin with labels.png|thumb|left|Chemical structure of [[oxytocin]]. Differs from AVP at only the 3rd and 8th position.]]
The vasopressins are [[peptide]]s consisting of nine [[amino acid]]s (nonapeptides). The amino acid sequence of arginine vasopressin (argipressin) is [[cysteine|Cys]]-[[tyrosine|Tyr]]-[[Phenylalanine|Phe]]-[[glutamine|Gln]]-[[asparagine|Asn]]-[[Cysteine|Cys]]-[[proline|Pro]]-[[arginine|Arg]]-[[glycine|Gly]]-NH<sub>2</sub>, with the cysteine residues forming a [[disulfide bond]] and the ''C''-terminus of the sequence converted to a [[primary amide]].<ref>{{cite book|url=https://books.google.com/books?id=BBLRUI4aHhkC&q=vasopressin+oxytocin+amino+acid+sequence&pg=PA1833|title=Tietz Textbook of Clinical Chemistry and Molecular Diagnostics| vauthors = Burtis CA, Ashwood ER, Bruns DE |publisher=[[Elsevier Health Sciences]]|year=2012|isbn=978-1-4557-5942-2|edition=5th|page=1833 }}</ref> Lysine vasopressin (lypressin) has a [[lysine]] in place of the arginine as the eighth amino acid, and is found in [[pig]]s and some related animals, whereas arginine vasopressin is found in humans.<ref>{{cite book |doi=10.1016/B978-0-7506-0167-2.50010-8 |chapter=Polyuria and Disorders of Thirst |chapter-url={{Google books|P3XbAgAAQBAJ|page=76|plainurl=yes}} |title=Scientific Foundations of Biochemistry in Clinical Practice |edition=2nd |pages=76–102 |year=1994 |publisher=[[Butterworth-Heinemann]] | vauthors = Donaldson D |isbn=978-0-7506-0167-2 | veditors = Williams DL, Marks V }}</ref>
The structure of [[oxytocin]] is very similar to that of the vasopressins: It is also a nonapeptide with a disulfide bridge and its amino acid sequence differs at only two positions. The two genes are located on the same chromosome separated by a relatively small distance of less than 15,000 bases in most species. The [[Magnocellular neurosecretory cell|magnocellular neurons]] that secrete vasopressin are adjacent to magnocellular neurons that secrete oxytocin, and are similar in many respects. The similarity of the two peptides can cause some cross-reactions: oxytocin has a slight antidiuretic function, and high levels of AVP can cause uterine contractions.<ref name="pmid18057218">{{cite journal | vauthors = Li C, Wang W, Summer SN, Westfall TD, Brooks DP, Falk S, Schrier RW | title = Molecular mechanisms of antidiuretic effect of oxytocin | journal = Journal of the American Society of Nephrology | volume = 19 | issue = 2 | pages = 225–32 | date = February 2008 | pmid = 18057218 | pmc = 2396735 | doi = 10.1681/ASN.2007010029 }}</ref><ref name="pmid15280526">{{cite journal | vauthors = Joo KW, Jeon US, Kim GH, Park J, Oh YK, Kim YS, Ahn C, Kim S, Kim SY, Lee JS, Han JS | display-authors = 6 | title = Antidiuretic action of oxytocin is associated with increased urinary excretion of aquaporin-2 | journal = Nephrology, Dialysis, Transplantation | volume = 19 | issue = 10 | pages = 2480–6 | date = October 2004 | pmid = 15280526 | doi = 10.1093/ndt/gfh413 | doi-access = free }}</ref>
'''Comparison of vasopressin and oxytocin neuropeptide families:'''
{| class="wikitable" width="80%"
! colspan="3" | '''[[Vertebrate]] Vasopressin Family'''
|-
| style="width:25em" |Cys-Tyr-'''Phe'''-Gln-Asn-Cys-Pro-'''Arg'''-Gly-NH<sub>2</sub> || [[Argipressin]] (AVP, ADH) || Most [[mammal]]s
|-
|Cys-Tyr-Phe-Gln-Asn-Cys-Pro-Lys-Gly-NH<sub>2</sub> || [[Lypressin]] (LVP) || [[Pig]]s, [[hippopotamus|hippos]], [[warthog]]s, some [[marsupial]]s
|-
|Cys-Phe-Phe-Gln-Asn-Cys-Pro-Arg-Gly-NH<sub>2</sub> || [[Phenypressin]] || Some [[marsupial]]s
|-
|Cys-Tyr-'''Ile'''-Gln-Asn-Cys-Pro-'''Arg'''-Gly-NH<sub>2</sub> || [[Vasotocin]]† || Non-mammals
|-
! colspan="3" | '''Vertebrate Oxytocin Family'''
|-
|Cys-Tyr-'''Ile'''-Gln-Asn-Cys-Pro-'''Leu'''-Gly-NH<sub>2</sub> || [[Oxytocin]] (OXT) || Most mammals, [[ratfish]]
|-
|Cys-Tyr-Ile-Gln-Asn-Cys-Pro-Pro-Gly-NH<sub>2</sub> || Prol-[[Oxytocin]] || Some [[New World monkey]]s, [[Northern Treeshrew|northern tree shrews]]
|-
|Cys-Tyr-Ile-Gln-Asn-Cys-Pro-Ile-Gly-NH<sub>2</sub> || [[Mesotocin]] || Most marsupials, all [[bird]]s, [[reptile]]s, [[amphibian]]s, [[lungfish]]es, [[coelacanth]]s
|-
|Cys-Tyr-Ile-Gln-Ser-Cys-Pro-Ile-Gly-NH<sub>2</sub> || [[Seritocin]] || [[Frog]]s
|-
|Cys-Tyr-Ile-Ser-Asn-Cys-Pro-Ile-Gly-NH<sub>2</sub> || [[Isotocin]] || [[Bony fish]]es
|-
|Cys-Tyr-Ile-Ser-Asn-Cys-Pro-Gln-Gly-NH<sub>2</sub> || [[Glumitocin]] || [[Skate (fish)|skate]]s
|-
|Cys-Tyr-Ile-Asn/Gln-Asn-Cys-Pro-Leu/Val-Gly-NH<sub>2</sub> || Various tocins || [[Shark]]s
|-
! colspan="3" | '''[[Invertebrate]] VP/OT Superfamily'''
|-
|Cys-Leu-Ile-Thr-Asn-Cys-Pro-Arg-Gly-NH<sub>2</sub> || [[Inotocin]] || [[Locust]]
|-
|Cys-Phe-Val-Arg-Asn-Cys-Pro-Thr-Gly-NH<sub>2</sub> || [[Annetocin]] || [[Earthworm]]
|-
|Cys-Phe-Ile-Arg-Asn-Cys-Pro-Lys-Gly-NH<sub>2</sub> || [[Lys-Connopressin]] || Geography & imperial [[cone snail]], [[pond snail]], [[sea hare]], [[leech]]
|-
|Cys-Ile-Ile-Arg-Asn-Cys-Pro-Arg-Gly-NH<sub>2</sub> || [[Arg-Connopressin]] || Striped cone snail
|-
|Cys-Tyr-Phe-Arg-Asn-Cys-Pro-Ile-Gly-NH<sub>2</sub> || [[Cephalotocin]] || [[Octopus]]
|-
|Cys-Phe-Trp-Thr-Ser-Cys-Pro-Ile-Gly-NH<sub>2</sub> || [[Octopressin]] || Octopus
|-
| colspan="3" | †Vasotocin is the evolutionary progenitor of all the vertebrate neurohypophysial hormones.<ref>{{cite journal|date=July 1995|title=The neurohypophysial endocrine regulatory cascade: precursors, mediators, receptors, and effectors|journal=Frontiers in Neuroendocrinology|volume=16|issue=3|pages=237–89|doi=10.1006/frne.1995.1009|pmid=7556852|vauthors=Acher R, Chauvet J|s2cid=12739464}}</ref>
|}
==Medical use==
{{Main|Vasopressin (medication)}}
Vasopressin is used to manage anti-diuretic hormone deficiency. Vasopressin is used to treat [[diabetes insipidus]] related to low levels of antiduretic hormone. It is available as Pressyn.<ref name="Davis2017">{{cite web|url=http://davisplus.fadavis.com/3976/meddeck/pdf/vasopressin.pdf|title=Vasopressin|date=2017|publisher=F.A. Davis Company|access-date=2017-03-13|url-status=dead}}{{dead link|date=March 2021}}</ref>
Vasopressin has off-label uses and is used in the treatment of vasodilatory shock, gastrointestinal bleeding, [[ventricular tachycardia]] and ventricular fibrillation.
Vasopressin agonists are used therapeutically in various conditions, and its long-acting synthetic analogue [[desmopressin]] is used in conditions featuring low vasopressin secretion, as well as for control of bleeding (in some forms of [[von Willebrand disease]] and in mild [[haemophilia A]]) and in extreme cases of bedwetting by children. [[Terlipressin]] and related analogues are used as [[vasoconstrictor]]s in certain conditions. Use of vasopressin analogues for [[esophageal varices]] commenced in 1970.<ref name="pmid5101576">{{cite journal | vauthors = Baum S, Nusbaum M | title = The control of gastrointestinal hemorrhage by selective mesenteric arterial infusion of vasopressin | journal = Radiology | volume = 98 | issue = 3 | pages = 497–505 | date = March 1971 | pmid = 5101576 | doi = 10.1148/98.3.497 }}</ref>
Vasopressin infusions are also used as second line therapy for [[septic shock]] patients not responding to fluid resuscitation or infusions of [[catecholamine]]s (e.g., [[dopamine]] or [[norepinephrine]]) to increase the blood pressure while sparing the use of catecholamines. These argipressins have much shorter elimination half-life (around 20 minutes) comparing to synthetic non-arginine vasopresines with much longer elimination half-life of many hours. Further, argipressins act on V1a, V1b, and V2 receptors which consequently lead to higher eGFR and lower vascular resistance in the lungs. A number of injectable arginine vasopressins are currently in clinical use in the United States and in Europe.
===Pharmacokinetics===
Vasopressin is administered through an [[Intravenous therapy|intravenous device]], [[intramuscular injection]] or a [[subcutaneous injection]]. The [[duration of action]] depends on the mode of administration and ranges from thirty minutes to two hours. It has a [[half life]] of ten to twenty minutes. It is widely distributed throughout the body and remains in the [[extracellular fluid]]. It is degraded by the [[liver]] and excreted through the [[kidney]]s.<ref name="Davis2017" /> Arginin vasopressins for use in septic shock are intended for intravenous use only.
=== Side effects ===
The most common side effects during treatment with vasopressin are [[dizziness]], [[angina]], chest pain, abdominal cramps, [[heartburn]], [[nausea]], [[vomiting]], trembling, [[fever]], [[water intoxication]], pounding sensation in the head, [[diarrhoea]], sweating, paleness, and [[flatulence]]. The most severe adverse reactions are [[myocardial infarction]] and [[hypersensitivity]].<ref name="Davis2017" />
===Contraindications===
The use of lysine vasopressin is contraindicated in the presence of hypersensitivity to beef or pork proteins, increased [[BUN]] and chronic [[kidney failure]]. It is recommended that it be cautiously used in instances of perioperative [[polyuria]], sensitivity to the drug, asthma, seizures, heart failure, a comatose state, migraine headaches, and cardiovascular disease.<ref name="Davis2017" />
===Interactions===
*[[alcohol (drug)|alcohol]] - may lower the antidiuretic effect
*[[carbamazepine]], [[chloropropamide]], [[clofibrate]], [[tricyclic antidepressants]] and [[fludrocortisone]] may raise the diuretic effect
*[[lithium]], [[demeclocycline]], [[heparin]] or [[norepinephrine]] may lower the antidiuretic effect
*vasopressor effect may be higher with the concurrent use of [[Ganglionic blocker|ganglionic blocking medications]]<ref name="Davis2017" />
==Role in disease==
There may be a connection between arginine vasopressin and autism.<ref name="Carson_2015">{{cite journal|year=2015|title=Arginine Vasopressin Is a Blood-Based Biomarker of Social Functioning in Children with Autism|journal=PLOS ONE|volume=10|issue=7|pages=e0132224|doi=10.1371/journal.pone.0132224|pmc=4511760|pmid=26200852|lay-source=Scientific American|vauthors=Carson DS, Garner JP, Hyde SA, Libove RA, Berquist SW, Hornbeak KB, Jackson LP, Sumiyoshi RD, Howerton CL, Hannah SL, Partap S, Phillips JM, Hardan AY, Parker KJ|lay-url=https://www.scientificamerican.com/article/vasopressin-emerges-as-hormone-of-interest-in-autism-research/|bibcode=2015PLoSO..1032224C}}</ref>
===Deficiency===
Decreased AVP release (neurogenic — i.e. due to alcohol intoxication or tumour) or decreased renal sensitivity to AVP (nephrogenic, i.e. by mutation of V2 receptor or AQP) leads to [[diabetes insipidus]], a condition featuring [[hypernatremia]] (increased blood [[sodium]] concentration), [[polyuria]] (excess urine production), and [[polydipsia]] (thirst).
===Excess===
<!--High levels of vasopressin secretion may lead to [[hyponatremia]]. In many cases, the vasopressin treatment and secretion is appropriate to treat hypovolemia.. In some cases such as ([[heart failure]], [[nephrotic syndrome]]) body fluid volume is increased but vasopression levels are not suppressed. for various reasons; this state is labelled "hypervolemic hyponatremia". A proportion of cases of hyponatremia feature neither hyper- nor hypovolemia. In this group (labelled "euvolemic hyponatremia"), AVP secretion is either driven by a lack of [[cortisol]] or [[thyroxine]] ([[hypoadrenalism]] and [[hypothyroidism]], respectively) or a very low level of urinary solute excretion ([[potomania]], low-protein diet), or it is entirely inappropriate. This last category is classified as the [[syndrome of inappropriate antidiuretic hormone]] (SIADH).<ref name=Verbalis2007>{{cite journal | vauthors = Verbalis JG, Goldsmith SR, Greenberg A, Schrier RW, Sterns RH | title = Hyponatremia treatment guidelines 2007: expert panel recommendations | journal = The American Journal of Medicine | volume = 120 | issue = 11 Suppl 1 | pages = S1-21 | date = November 2007 | pmid = 17981159 | doi = 10.1016/j.amjmed.2007.09.001 }}</ref>-->
{{Main|Syndrome of inappropriate antidiuretic hormone secretion}}
[[Syndrome of inappropriate antidiuretic hormone secretion|Syndrome of Inappropriate Antidiuretic Hormone secretion (SIADH)]] in turn can be caused by a number of problems. Some forms of [[cancer]] can cause SIADH, particularly [[small cell lung carcinoma]] but also a number of other tumors. A variety of diseases affecting the brain or the lung (infections, bleeding) can be the driver behind SIADH. A number of drugs have been associated with SIADH, such as certain antidepressants ([[serotonin reuptake inhibitor]]s and [[tricyclic antidepressant]]s), the anticonvulsant [[carbamazepine]], [[oxytocin]] (used to induce and stimulate labor), and the chemotherapy drug [[vincristine]]. It has also been associated with [[Quinolones|fluoroquinolones]] (including [[ciprofloxacin]] and [[moxifloxacin]]).<ref name="babar2013" /> Finally, it can occur without a clear explanation.<ref name="Verbalis2007">{{cite journal|date=November 2007|title=Hyponatremia treatment guidelines 2007: expert panel recommendations|journal=The American Journal of Medicine|volume=120|issue=11 Suppl 1|pages=S1–21|doi=10.1016/j.amjmed.2007.09.001|pmid=17981159|vauthors=Verbalis JG, Goldsmith SR, Greenberg A, Schrier RW, Sterns RH|citeseerx=10.1.1.499.7585}}</ref> Hyponatremia can be treated pharmaceutically through the use of [[vasopressin receptor antagonist]]s.<ref name="Verbalis2007" />
==History==
Vasopressin was elucidated and synthesized for the first time by [[Vincent du Vigneaud]].
== Animal studies ==
Evidence for an effect of AVP on monogamy vs polygamy comes from experimental studies in several species, which indicate that the precise distribution of vasopressin and vasopressin receptors in the brain is associated with species-typical patterns of social behavior. In particular, there are consistent differences between monogamous species and polygamous species in the distribution of AVP receptors, and sometimes in the distribution of vasopressin-containing axons, even when closely related species are compared.<ref name="Young2009">{{cite journal|date=October 2009|title=The neuroendocrinology of the social brain|journal=Frontiers in Neuroendocrinology|volume=30|issue=4|pages=425–8|doi=10.1016/j.yfrne.2009.06.002|pmid=19596026|vauthors=Young LJ|s2cid=31960688}}</ref>
== Human studies ==
Vasopressin has shown [[nootropic]] effects on pain perception and cognitive function.<ref name="pmid25853137">{{cite journal | vauthors = Mavani GP, DeVita MV, Michelis MF | title = A review of the nonpressor and nonantidiuretic actions of the hormone vasopressin | journal = Frontiers in Medicine | volume = 2 | pages = 19 | date = 2015 | pmid = 25853137 | pmc = 4371647 | doi = 10.3389/fmed.2015.00019 }}</ref> Vasopressin also plays a role in [[autism]], [[major depressive disorder]], [[bipolar disorder]], and [[schizophrenia]].<ref name="pmid29468985">{{cite journal | vauthors = Iovino M, Messana T, De Pergola G, Iovino E, Dicuonzo F, Guastamacchia E, Giagulli VA, Triggiani V | title = The Role of Neurohypophyseal Hormones Vasopressin and Oxytocin in Neuropsychiatric Disorders | journal = Endocrine, Metabolic & Immune Disorders Drug Targets | volume = 18 | issue = 4 | pages = 341–347 | date = 2018 | pmid = 29468985 | doi = 10.2174/1871530318666180220104900 }}</ref>
== Glej tudi ==
* [[hipofiza]]
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