Role of vasopressin and its antagonism in stroke related edema |
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| Authors: | Pouya A. Ameli Neema J. Ameli David M. Gubernick Saeed Ansari Shekher Mohan Irawan Satriotomo Alexis K. Buckley Christopher W. Maxwell Jr. Vignesh H. Nayak Vishnumurthy Shushrutha Hedna |
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| Affiliation: | 1. University of Central Florida College of Medicine, Orlando, Florida;2. Department of Neurology, University of Florida College of Medicine, Gainesville, Florida;3. Department of Surgery, University of Florida College of Medicine, Gainesville, Florida;4. Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida |
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| Abstract: | Although many approaches have been tried in the attempt to reduce the devastating impact of stroke, tissue plasminogen activator for thromboembolic stroke is the only proved, effective acute stroke treatment to date. Vasopressin, an acute‐phase reactant, is released after brain injury and is partially responsible for the subsequent inflammatory response via activation of divergent pathways. Recently there has been increasing interest in vasopressin because it is implicated in inflammation, cerebral edema, increased intracerebral pressure, and cerebral ion and neurotransmitter dysfunctions after cerebral ischemia. Additionally, copeptin, a byproduct of vasopressin production, may serve as a promising independent marker of tissue damage and prognosis after stroke, thereby corroborating the role of vasopressin in acute brain injury. Thus, vasopressin antagonists have a potential role in early stroke intervention, an effect thought to be mediated via interactions with aquaporin receptors, specifically aquaporin‐4. Despite some ambiguity, vasopressin V1a receptor antagonism has been consistently associated with attenuated secondary brain injury and edema in experimental stroke models. The role of the vasopressin V2 receptor remains unclear, but perhaps it is involved in a positive feedback loop for vasopressin expression. Despite the encouraging initial findings we report here, future research is required to characterize further the utility of vasopressin antagonists in treatment of stroke. © 2014 Wiley Periodicals, Inc. |
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| Keywords: | vasopressin vasopressin antagonism stroke aquaporin cerebral edema brain injury |
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