Evaluation of the Secretory Pattern of Plasma Arginine Vasopressin in Stroke Patients

Abstract

Arginine vasopressin (AVP) may play a role in the development of ischemic brain edema and/or cerebral vasospasm. Data available on AVP plasma levels in ischemic stroke are few and discordant. In order to ascertain whether changes in AVP plasma levels occur in ischemic stroke, plasma AVP levels, plasma osmolality and mean arterial pressure were determined in 24 patients with unprecedented ischemic cerebral infarction and in 15 controls over a 24-hour period. In stroke patients, mean 24-hour plasma AVP levels (7.2 ± 0.8 ng/l) were higher (p < 0.05) than in control subjects (2.4 ± 0.3 ng/l), and correlated with the severity score of the neurologic deficit and the mean size of the lesion. In patients with a more severe neurologic deficit, the mean 24-hour plasma AVP levels (8.7 ± 1.0 ng/l) were higher than in patients with a less severe neurologic deficit (5.2 ± 0.8 ng/l). Data indicate that in ischemic stroke an increased AVP secretion occurs independently of osmotic or baroreceptorial mechanisms. The possibility that AVP may play a role in neuronal cell damage following cerebral ischemia warrants further attention.

Multiple Sites of Vasopressin Synthesis in the Injured Brain

“…Traumatic or ischemic brain injury has previously been reported to be accompanied by elevated concentrations of AVP in the plasma (Barreca et al, 2001;Xu et al, 2007). Consistent with these clinical findings, we showed that TBI results in a significant upregulation of hypothalamic synthesis of AVP.…”

Vasopressin V1a and V1b Receptors: From Molecules to Physiological Systems

“…In stroke patients, mean 24-h plasma AVP levels are higher than in control subjects and correlate with the severity score of the neurological deficit and the mean size of the lesion (42). In a controlled cortical impact model of brain injury, AVP synthesis was increased in activated microglia and macrophages and in the hypothalamus and cerebral cortex adjacent to the posttraumatic lesion (477).…”

Role of Arginine Vasopressin V1 and V2 Receptors for Brain Damage After Transient Focal Cerebral Ischemia

“…The amount of AVP mRNA and of AVP protein increase after experimental cerebral ischemia (Liu, 1992;Liu et al, 2000) and levels of AVP are elevated in the CSF of stroke patients (Barreca et al, 2001).…”

“…Cerebral ischemia induces AVP mRNA (Liu et al, 2000) and protein (Liu, 1992) expression, and increased AVP plasma levels have been reported in stroke patients (Barreca et al, 2001). Application of AVP exacerbates acute ischemic brain edema (Liu et al, 1991;Dickinson and Betz, 1992;Ikeda et al, 1997) and this exacerbation can be reduced by AVP antiserum (Liu et al, 1991) or by the AVP release inhibitor RU51559 (Ikeda et al, 1997).…”