Vasopressin and copeptin release during sepsis and septic shock

Gomes, Dayane Aparecida; Beltrão, Raphaelle Lima de Almeida; Oliveira, F; Silva, José Carlos da; Arruda, Eduarda Patrícia Carneiro de; Lira, Eduardo Carvalho; Rocha, Maria José Alves da

doi:10.1016/j.peptides.2020.170437

Cited by 28 publications

(23 citation statements)

References 80 publications

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“…Copeptin is a plasma AVP marker and has been used for predicting tolvaptan’s effect in other diseases [26, 27]. AVP was measured in the present study, but the accuracy was limited by the instability and short half-life of AVP compared with copeptin [28]. Another limitation of our study is that we were unable to assess the relationship between copeptin and the prognosis for liver disease-related events.…”

Section: Discussionmentioning

confidence: 93%

Plasma Renin Activity Predicts Prognosis and Liver Disease-Related Events in Liver Cirrhosis Patients with Ascites Treated by Tolvaptan

Oswald

Nakanishi

Kurosaki

et al. 2021

Dig Dis

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Background and Aims: A retrospective study was to analyze the association of plasma renin activity (PRA) with overall survival and liver disease-related events in decompensated liver cirrhosis with ascites treated by tolvaptan. Methods: We included 196 patients with decompensated cirrhosis treated with tolvaptan and for whom hepatic ascites had remained uncontrolled by conventional diuretics. Factors associated with prognosis and appearance of liver disease-related events were investigated, including vasopressin, sympathetic nervous system hormones (adrenaline, noradrenaline, and dopamine), and the renin-angiotensin system (PRA and aldosterone) at the beginning of tolvaptan treatment. Results: Age, history of hepatocellular carcinoma (HCC), and PRA were identified as independent factors for prognosis after tolvaptan treatment. The median survival time in patients with PRA ≥9.5 ng/mL/h at the beginning of tolvaptan treatment was significantly shorter than in patients with PRA <9.5 ng/mL/h (193 vs. 893 days, p < 0.001). PRA and a history of HCC were independent factors for the occurrence of liver disease-related events. The median event-free period in patients with PRA ≥3.2 ng/mL/h was significantly shorter than that of patients with PRA <3.2 ng/mL/h (89 vs. 222 days, p < 0.001). Conclusions: PRA is an independent predictor of prognosis and appearance of liver disease-related events in patients with decompensated cirrhosis who have started tolvaptan treatment.

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Section: Discussionmentioning

confidence: 93%

Plasma Renin Activity Predicts Prognosis and Liver Disease-Related Events in Liver Cirrhosis Patients with Ascites Treated by Tolvaptan

Oswald

Nakanishi

Kurosaki

et al. 2021

Dig Dis

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“…However, this peptide may have a role during intracellular processing of provasopressin, which contributes to the correct structural formation of the AVP precursor, which in turn leads to efficient proteolytic maturation ( 38 ). Despite unknown function, copeptin has been described as a surrogate of AVP for physiological conditions and in different diseases ( 39 ). Several studies found copeptin to be increased in different types of infections and to be associated with short-term mortality ( 40 , 41 ).…”

Section: Discussionmentioning

confidence: 99%

Risk assessment of sepsis through measurement of proAVP (copeptin): a secondary analysis of the TRIAGE study

Kloter

Gregoriano

Haag

et al. 2021

Endocrine Connections

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Objective: Systemic infections and sepsis lead to a strong activation of the vasopressin system, which is pivotal for stimulation of the endocrine stress response and in addition has vasoconstrictive and immunomodulatory effects. Our aim was to assess the significance of the vasopressor system through measurement of C-terminal proAVP (copeptin) regarding mortality prediction in a large prospective cohort of patients with systemic infection. Design and Methods: This secondary analysis of the observational cohort TRIAGE study included consecutive, adult, medical patients with an initial diagnosis of infection seeking emergency department care. We used multivariable regression analysis to assess associations of copeptin levels in addition to the sequential organ failure assessment (SOFA) score with 30-day mortality. Discrimination was assessed by calculation of the area under the curve (AUC). Results: Overall, 45 of 609 (7.4%) patients with infection died within 30 days. Non-survivors had a marked upregulation of the vasopressin system with a more than 4-fold increase in admission copeptin-levels compared to non-survivors (199.9 ± 204.7 vs. 46.6 ± 77.2 pmol/L). In a statistical model copeptin was significantly associated with mortality (adjusted odds ratio of 1.04, 95% CI 1.01 to 1.07, p=0.002). Regarding discrimination, copeptin alone showed an AUC of 0.82, while adding copeptin to the SOFA score significantly improved its prognostic ability (AUC 0.83 vs. 0.86, p=0.027). Conclusion: Activation of vasopressin system mirrored by an increase in copeptin levels provided significant information regarding mortality risk and improved the SOFA score for prediction of sepsis mortality. Trial registration: ClinicalTrials.gov NCT01768494. Registered January 9, 2013

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“…Indeed, in a study looking at copeptin and cortisol concentrations in 3 groups with increasing stress levels (ie, healthy volunteers without stress, hospitalized medical patients with moderate stress, and surgical patients immediately after extubation with maximal stress), copeptin levels showed a step-wise increase, correlating with cortisol concentrations ( 95 ).This positive correlation of copeptin with the individual stress level, mirroring disease severity, builds the rationale for a presumed prognostic value of copeptin in several acute diseases. For example, copeptin has been shown to be a prognostic biomarker in sepsis ( 96 ), pulmonary ( 97 , 98 ), cardiovascular ( 99 , 100 ), neurological ( 86 , 101 ), hepatic ( 102 ), and urinary ( 103 ) diseases.…”

Section: Utility Of Copeptin Measurement In Other Diseasesmentioning

confidence: 99%

Approach to the Patient: “Utility of the Copeptin Assay”

Refardt

Winzeler

2022

The Journal of Clinical Endocrinology &Amp; Metabolism

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Copeptin derives from the same precursor peptide Pre-Pro-Vasopressin than Arginine Vasopressin (AVP). The secretion of both peptides is stimulated by similar physiological processes, such as osmotic stimulation, hypovolemia or stress. AVP is difficult to measure due to complex pre-analytical requirements and due to technical difficulties. In the last years, copeptin was found to be a stable, sensitive and simple to measure surrogate marker of AVP release. Different immunoassays exist to measure copeptin. The two assays which have most often be used in clinical studies are the original sandwich immunoluminometric assay and its automated immunofluorescent successor. In addition, various ELISA assays have been developed. With the availability of the copeptin assay, the differential diagnosis of diabetes insipidus was recently revisited. The goal for this article is therefore to first review the physiology of copeptin and second, to describe its use as marker for the differential diagnosis of vasopressin-dependent fluid disorders, mainly diabetes insipidus but also hyper- and hyponatremia. Furthermore, we highlight the role of copeptin as prognostic marker in other acute and chronic diseases.

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Vasopressin and copeptin release during sepsis and septic shock

Cited by 28 publications

References 80 publications

Plasma Renin Activity Predicts Prognosis and Liver Disease-Related Events in Liver Cirrhosis Patients with Ascites Treated by Tolvaptan

Plasma Renin Activity Predicts Prognosis and Liver Disease-Related Events in Liver Cirrhosis Patients with Ascites Treated by Tolvaptan

Risk assessment of sepsis through measurement of proAVP (copeptin): a secondary analysis of the TRIAGE study

Approach to the Patient: “Utility of the Copeptin Assay”

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