To discuss the role of autocrine/paracrine signaling of urothelial arginine vasopressin (AVP) on mammalian bladder capacities and micturition thresholds, impact of distension on water/urea reabsorption from the bladder, review of the literature to better characterize the central/peripheral effects of AVP, desmopressin (dAVP) toxicity, and urine biomarkers of nocturia.
This review summarizes discussions during an International Consultation on Incontinence-Research Society 2024 think tank with respect to the role of urothelial AVP in aged individuals with nocturnal polyuria, impact of solute and water reabsorption by the bladder on uninterrupted sleep, central effects of AVP, pharmacological basis of dAVP toxicity, and biomarkers in nocturia/lower urinary tract dysfunction (LUTD) with neurological diseases.
Consensus recognized AVP function and pathways in the central nervous system (CNS), pre-proAVP localized using immunohistochemistry in bladder sections from adult/aged noncancerous human punch biopsies and rodent bladder sections is likely to accelerate the systemic uptake of water and urea from the bladder of anesthetized mice instilled with 3H-water and 14C-urea. Mechanisms for charged and uncharged solutes and water transport across the bladder, mechanism of dAVP toxicity, and utility of urine biomarkers in those with neurological diseases/nocturia were determined from literature reviews.
Pre-proAVP is present in human/rodent bladders and may be involved in water reabsorption from bladder that prevents the sensation of fullness for uninterrupted sleep in healthy adults. The mechanism of action of AVP in the CNS was discussed, as was electrolyte/water transport across the bladder, the basis for dAVP toxicity, and feasibility of urine biomarkers to identify nocturia/LUTD with neurological diseases.
Neurourology and urodynamics. 2024 Jul 25 [Epub ahead of print]
Anthony Kanai, Karel Everaert, Apostolos Apostolidis, Christopher Fry, Pradeep Tyagi, Andries Van Huele, Bahareh Vahabi, Wendy Bower, Alan Wein, Paul Abrams
Department of Medicine, Renal Electrolyte Division, University of Pittsburgh, Philadelphia, Pennsylvania, USA., Department of Urology, Ghent University, Gent, Belgium., 2ND Department of Urology, Aristotle University, Thessaloniki, Greece., School of Physiology, Pharmacology & Neuroscience, University of Bristol, Bristol, UK., Department of Urology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA., School of Applied Sciences, University of the West of England, Bristol, UK., Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia., Desai Sethi Institute of Urology, University of Miami Miller School of Medicine, Florida, USA., Bristol Urological Institute, Bristol, UK.