Arginine Vasopressin and Posterior Reversible Encephalopathy Syndrome Pathophysiology: the Missing Link?

Posterior reversible encephalopathy syndrome (PRES) is a clinicoradiological entity characterized by a typical brain edema. Its pathogenesis is still debated through hypoperfusion and hyperperfusion theories, which have many limitations. As PRES occurs almost exclusively in clinical situations with...

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Veröffentlicht in:Molecular neurobiology 2019-10, Vol.56 (10), p.6792-6806
Hauptverfasser: Largeau, Bérenger, Le Tilly, Olivier, Sautenet, Bénédicte, Salmon Gandonnière, Charlotte, Barin-Le Guellec, Chantal, Ehrmann, Stephan
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container_issue 10
container_start_page 6792
container_title Molecular neurobiology
container_volume 56
creator Largeau, Bérenger
Le Tilly, Olivier
Sautenet, Bénédicte
Salmon Gandonnière, Charlotte
Barin-Le Guellec, Chantal
Ehrmann, Stephan
description Posterior reversible encephalopathy syndrome (PRES) is a clinicoradiological entity characterized by a typical brain edema. Its pathogenesis is still debated through hypoperfusion and hyperperfusion theories, which have many limitations. As PRES occurs almost exclusively in clinical situations with arginine vasopressin (AVP) hypersecretion, such as eclampsia and sepsis, we hypothesize that AVP plays a central pathophysiologic role. In this review, we discuss the genesis of PRES and its symptoms through this novel approach. We theorize that AVP axis stimulation precipitates PRES development through an increase in AVP secretion or AVP receptor density. Activation of vasopressin V 1 a receptors leads to cerebral vasoconstriction, causing endothelial dysfunction and cerebral ischemia. This promotes cytotoxic edema through hydromineral transglial flux dysfunction and may increase endothelial permeability, leading to subsequent vasogenic brain edema. If our hypothesis is confirmed, it opens new perspectives for better patient monitoring and therapies targeting the AVP axis in PRES.
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subjects Animals
Arginine Vasopressin - metabolism
Argipressin
Argipressin receptors
Biomarkers - metabolism
Biomedical and Life Sciences
Biomedicine
Brain
Cell Biology
Comorbidity
Cytotoxicity
Disease Susceptibility
Eclampsia
Edema
Encephalopathy
Human health and pathology
Humans
Ischemia
Life Sciences
Models, Biological
Neurobiology
Neurology
Neurosciences
Permeability
Posterior Leukoencephalopathy Syndrome - pathology
Posterior Leukoencephalopathy Syndrome - physiopathology
Receptor density
Secretion
Sepsis
Vasoconstriction
Vasopressin
title Arginine Vasopressin and Posterior Reversible Encephalopathy Syndrome Pathophysiology: the Missing Link?
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