pituitrin and Cadaver

ADH is a hormone secreted by neurohypophysis that plays different roles based on the target organ. At the renal level, this peptide is capable of causing electrolyte-free water absorption, thus playing a key role in the hydro-electrolytic balance. There are pathologies and disorders that jeopardize this balance and, in this field, ADH receptor inhibitors such as Vaptans could play a key role. By inhibiting the activation pathway of vasopressin, they are potentially useful in euvolemic and hypervolemic hypotonic hyponatremia. However, clinical trials in heart failure have not given favourable results on clinical outcomes. Even in SIADH, despite their wide use, there is no agreement by experts on their use. Since vaptans inhibit the cAMP pathway in tubular cells, their use has been proposed to inhibit cystogenesis. A clinical trial has shown favourable effects on ADPKD progression. Because vaptans have been shown to be effective in models of renal cysts disorders other than ADPKD, their use has been proposed in diseases such as nephronophthisis and recessive autosomal polycystic disease. Other possible uses of vaptans could be in kidney transplantation and cardiorenal syndrome. Due to the activity of ADH in coagulation and haemostasis, ADH's activation pathway by Desmopressin Acetate could be a useful strategy to reduce the risk of bleeding in biopsies in patients with haemorrhagic risk.

Topics: Antidiuretic Hormone Receptor Antagonists; Cadaver; Cyclic AMP; Forecasting; Humans; Hyponatremia; Kidney Diseases; Kidney Diseases, Cystic; Kidney Transplantation; Kidney Tubules, Collecting; Molecular Targeted Therapy; Neurophysins; Polycystic Kidney, Autosomal Dominant; Protein Precursors; Receptors, Vasopressin; Second Messenger Systems; Tissue Donors; Vasopressins; Water-Electrolyte Imbalance

The hypothalamic nonapeptide vasopressin is a known player in the pathogenesis of chronic heart failure. According to the large body of clinical evidence, vasopressin has an impact on salt and water imbalance, hyponatremia, and subsequent renal insufficiency - the most common and destructive co-morbidity of patients afflicted with chronic heart failure. Despite the well-documented elevated levels of vasopressin in the blood of such patients, its expression in the magnocellular hypothalamic nuclei and transport to the posterior pituitary has not yet been investigated. In addition, the literature almost lacks the information on the contribution of another member of nonapeptide family, oxytocin, in the pathogenesis of this disease. Here we present a postmortem analysis of vasopressin and oxytocin-immunoreactive neurons and their terminals in the posterior pituitary of 8 male patients (53.8+/-9.3 years) who had died from CHF and 9 male controls (54.6+/-11.8 years). In line with previous clinical reports, our study on hypothalami of chronic heart failure patients revealed a significant increase in the relative profile density (+29%) of vasopressin-positive neurons in the hypothalamic supraoptic nucleus. Consistently we found a significant increase in the relative optic density of vasopressin-immunoreactivity in the posterior pituitary (+33%) of these patients. In contrast, the similar analysis applied for oxytocin neurons revealed no statistically significant differences to controls. In conclusion, our study provides the morphological evidence for activation of vasopressin (but not oxytocin) expression and vasopressin transport to the posterior pituitary in patients with chronic heart failure.

Topics: Cadaver; Chronic Disease; Gene Expression; Heart Failure; Humans; Hypothalamo-Hypophyseal System; Male; Middle Aged; Oxytocin; Vasopressins

The use of desmopressin and vasopressors in cadaveric organ donors is considered a risk factor for graft dysfunction following pancreas transplantation by influencing the microcirculation. The aim of this study was to investigate the influence of these substances on early graft function.. This single-center retrospective trial included 59 patients who underwent simultaneous or solitary pancreas transplantation. The corresponding donor charts were reviewed for the use of vasopressors and desmopressin. Impaired graft function was determined as graft thrombosis or as insulin-dependence for more then 3 days posttransplant. Daily amylase and lipase concentrations from abdominal drains were measured to quantify reperfusion pancreatitis and fistula formation.. Overall, pancreas thrombosis was observed in 4 of 59 (6.8%) recipients. There were no significant differences in thrombosis rate whether the donors received desmopressin (3/38 vs 1/21, P >.1) or the needed vasopressors (3/53 vs 1/9, P >.1). The number of patients who required insulin for more than 3 days posttransplant was comparable whether the donors received desmopressin (9/38 vs 4/21, P >.1), or vasopressors (9/46 vs 3/8, P >.1). At present all recipients with functioning pancreatic grafts (ie, 92.7%) are free of exogenous insulin therapy at 2 to 80 months posttransplant. The amylase/lipase concentrations of peritoneal fluid were independent of the administration of desmopressin or vasopressors in the donors.. In this study donor desmopressin and vasopressor administration did not influence graft function after pancreas transplantation.

Topics: Adult; Cadaver; Cause of Death; Deamino Arginine Vasopressin; Diabetes Mellitus, Type 1; Drainage; Female; Humans; Insulin; Kidney Transplantation; Male; Middle Aged; Organ Preservation; Pancreas Transplantation; Retrospective Studies; Tissue Donors; Treatment Outcome; Vasopressins

Previously, alterations in neuronal metabolism were found in a number of brain areas of Alzheimer disease (AD) patients. In the present study we aimed at determining for the first time whether metabolic changes would also occur in vascular dementia (VD) patients in the supraoptic (SON), infundibular (INF), tuberomamillary (TMN), medial mamillary nuclei, vertical limb of the diagonal band of Broca (VDB), and nucleus basalis of Meynert. The Golgi complex (GC) size, cell size, and vasopressin mRNA levels (in the SON) were used as measures of neuronal metabolic activity in postmortem material. The GC immunoreactivity was clearly diminished in the SON, INF and TMN and was increased in the VDB of VD cases. Interestingly, in the SON and TMN, a decrease in the GC size was more pronounced in male than in female VD patients in accordance with the higher prevalence of VD in men. In 7 of 11 VD cases, vasopressin mRNA levels were significantly reduced which may contribute to urinary incontinence, one of the most common clinical symptoms in VD, and to the lower blood pressure values that are often registered at the later stages of the VD. Since the human TMN is the sole source of cerebral histamine, our data suggest deficient histaminergic transmission in the brain in VD. Diminished neuronal metabolism in the SON and INF was not observed in AD in this and previous studies, whereas the changes in the VDB and TMN are similar in VD and AD. In the present study we thus found decreased metabolic activity in several hypothalamic nuclei in VD indicating diminished production of certain hormones and neurotransmitters.

Topics: Aged; Aged, 80 and over; Cadaver; Cell Size; Dementia, Vascular; Female; Golgi Apparatus; Humans; Hypothalamus; In Situ Hybridization; Male; Middle Aged; Prosencephalon; RNA, Messenger; Tissue Distribution; Vasopressins

Topics: Adolescent; Adult; Aldosterone; Atrial Natriuretic Factor; Blood Pressure; Brain Death; Cadaver; Cause of Death; Creatinine; Diuresis; Female; Histocompatibility Testing; Humans; Kidney Transplantation; Male; Middle Aged; Renin; Tissue Donors; Vasopressins

In an earlier study we found more than twice as many vasopressin (AVP) neurons in the suprachiasmatic nucleus (SCN) of homosexual men as compared to heterosexual men. The present measurements in the same individuals showed that there is no difference in the number of vasoactive intestinal polypeptide (VIP)-expressing neurons in the SCN. The reduced nuclear diameter of both VIP and AVP neurons in the SCN as found in homosexual men points to metabolic alterations in the SCN in relation to sexual orientation.

Topics: Adult; Arginine Vasopressin; Cadaver; Cell Count; Homosexuality, Male; Humans; Male; Neurons; Sexual Behavior; Suprachiasmatic Nucleus; Vasoactive Intestinal Peptide; Vasopressins

Topics: Arginine Vasopressin; Cadaver; Female; Humans; Hypothalamo-Hypophyseal System; Hypothalamus; Oxytocics; Oxytocin; Pharmacology; Pituitary Gland; Pituitary Gland, Posterior; Rats; Tissue Extracts; Uterus; Vasopressins