Vasopressin Also known as Arginine vasopressin(AVP) or Anti Diuretic hormone(ADH). It is secreted by posterior lobe o pituitary. !

alled vasopressin because it can constrict arterioles. "oth the posterior lobe hormones ie AVP and #$ytocin are %ona&peptides ie have %ine Aminoacid se'uence. (he hormone is secreted in the )upraoptic and Paraventricular nuclei o Hypothalamus and transported down the a$ons o these neurons to their endings in the posterior lobe o pituitary. )ecreted as precursor molecule* Prepropressophysin (in the ribosome o the neuron) processed in the +ndoplasmic reticulum packaged into secretory granules called Herring "odies* in the golgi apparatus granules are carried by a$onic low to the nerve endings in the posterior pituitary. %eurons generate action potential action potential reaching the terminal end !a, , dependent e$ocytosis. AVP and Oxytocin are also secreted in .onads Adrenal corte$ (hymus (only o$ytocin) AVP Receptors Vasopressin receptors are o / typesV1A: Act through phophotidyl inositol pathway 0!a,, level It is ound in 1iver and "rain. !auses .lycogenolysis and is neurotransmitter in !%) V1B : Also act through phophotidyl inositol pathway 0!a,, level 2ound in Anterior Pituitary. !ause increased A!(H secretion. V2 : Act through .s mediated c.3P pathway. 2ound in 4idney. 5esponsible or water absorption. AVP acts on the Principal cells o the collecting duct. (he action o AVP is mediated through V2 receptors. It involves insertion o protein&water channel (A'uaporin 6) in the luminal sur ace o the principal cell o collecting duct. In a typical 78&kg adult* the kidney ilters about 9:8 1 ;d o plasma. # this* appro$imately 9<< 1 (:8=) is reabsorbed isosmotically in the pro$imal tubule and another : 1 (< to >=) is reabsorbed without solute in the descending limb o Henle?s loop. (he remainder is diluted to an osmolality o about @8 mmol;kg by selective reabsorption o sodium and chloride in the ascending limb. In the absence o AVP* the urine issuing rom the loop passes largely unmodi ied through the distal tubules and collecting ducts* resulting in a ma$imum water diuresis. In the presence o AVP* solute& ree water is reabsorbed osmotically through the principal cells o the collecting ducts* resulting in the e$cretion o a much smaller volume o concentrated urine.

Mechanism of Action: (his antidiuretic e ect is mediated via a . protein&coupled V 6 receptor that increases intracellular cyclic A3P* thereby inducing translocation o a'uaporin 6 (AAP6) water channels into the apical membrane. (he resultant increase in permeability permits an in lu$ o water that di uses out o the cell through AAP/ and AAP< water channels on the basal&lateral sur ace. (he net rate o lu$ across the cell is determined by o the number o AAP6 water channels in the apical membrane and o the strength o the osmotic gradient between tubular luid and the renal medulla. (ight Bunctions on the lateral sur ace o the cells serve to prevent unregulated water low.
Figure 1: Action of AV

A!uaporins are water channels. (here are > typesA'uaporin 9* 6 C / ound in 4idney A'uaporin < ound in "rain A'uaporin > ound in salivary gland* lacrimal gland and respiratory tract It is the Aquaporin 2 which is responsible for AVH mediated water absorption.

"ontrol of AV

secretion

(he secretion o AVP is regulated primarily by the De ectiveD osmotic pressure o body luids. E %ormal #smotic pressure is 6:8&6F@ mosm;kg H6#G

(his control is mediated by specialiHed cells* known as osmoreceptors* located in the anteromedial hypothalamus near the supraoptic nucleus. (hey have inhibitory as well as stimulatory components that regulate AVP secretion around a speci ic set point. (hus* when plasma osmolality;sodium are depressed to a certain minimum or threshold level o I6:8 mosmol;kg or 9/> me';1* respectively* plasma AVP is suppressed to low or undetectable levels and a water diuresis ensues. !onversely* when plasma osmolality;sodium rise above this Dthreshold*D plasma AVP rises steeply in direct proportion* reaching a concentration su icient to produce a ma$imum antidiuresis when plasma osmolality;sodium reach I6F> mosmol;kg and 9</ me';1. AVP secretion can also be in luenced by acute changes in blood volume or pressure (his baroregulation is mediated largely by neuronal a erents that originate in pressure receptors o the cardiac atria* aorta* and carotid arteriesJ proBect via the vagus and glossopharyngeal nerves to the nucleus tractus solitarius o the brain stemJ and then ascend to the paraventricular and supraoptic nucleii o the hypothalmus. (hese pathways regulate AVP release by maintaining a tonic inhibitory tone that decreases when blood volume or pressure alls by K98 to 68=. AVP can also directly constrict arterioles hence called vasopressin. (his baroregulatory system is probably o minor importance in the physiology o AVP secretion because the hemodynamic changes re'uired to a ect it are larger than those usually occurring in the course o normal activities. AVP secretion can also be stimulated by a variety o other nonosmotic variables including nausea* acute hypoglycemia* glucocorticoid de iciency* smoking* and* possibly* hyperangiotensinemia. (he emetic stimuli are e$tremely potent since they typically elicit immediate* >8& to 988& old increases in plasma AVP* even when the nausea is transient and unassociated with vomiting. (hey act via the emetic center in the medulla and can be completely blocked by treatment with antiemetics such as luphenaHine. )ummary o !ontrol o AVH secretion #ncreased AVP secretion 0#smotic pressure L +!2 +motion* )tress %ausea* Vomiting )tanding Angiotensin II $ecreased AVP secretion L #smotic pressure 0 +!2 Alcohol

Diabetes Insipidus
!aused by decreased secretion or action o AVP. !haracterised by abnormally large vol o dilute urine. 6< hr Mrine vol K >8ml;4g wt and osmolarity N/88 mosm;1 (reatment- DDAVP (Desmopressin) O is a synthetic AVP. Acts on V6 receptor.