Central AVP and blood pressure regulation: relevance to interspecies differences and hypertension

Intravenous hemostats: challenges in translation to patients

Excessive bleeding and the resulting complications are a leading killer of young people globally. There are many successful methods to halt bleeding in the extremities, including compression, tourniquets, and dressings. However, current treatments for internal hemorrhage (including from head or truncal injuries), termed non-compressible bleeding, are inadequate. For these non-compressible injuries, blood transfusions are the current treatment standard. However, they must be refrigerated, may potentially transfer disease, and are of limited supply. In addition, time is of the essence for halting hemorrhage, since more than a third of civilian deaths due to hemorrhage from trauma occur before the patient even reaches the hospital. As a result, particles that can cross-link activated platelets through the glycoprotein IIb/IIIa receptor expressed on activated platelets are being investigated as an alternative treatment for non-compressible bleeding. Ideally, these particles would interact specifically with platelets to stabilize the platelet plug. Initial designs used biologically derived microparticles with red blood cell fragment or albumin cores decorated with RGD or fibrinogen, which bind to GPIIb/IIIa. More recently there has been research into the use of fully synthetic nanoparticles with liposomal or polymer cores that crosslink platelets through a targeting peptide bound to the surface. Some of the challenges for the development of these particles include appropriate sizing to prevent blocking the capillaries of the lungs, immune system evasion to prevent strong reactions and increase circulation time, and storage and resuspension so that first responders can easily use the particles. In addition, the effectiveness of the variety of animal bleeding models in predicting outcomes must be examined before test results can be fully understood. Progress has been made in the development of particles to combat hemorrhage, but issues of immune sensitivity and storage must be resolved before these types of particles can be translated for human use.

Enhancement of central pressor effect of AVP in SHR and WKY rats by intracranial N(G)-nitro-L-arginine

The aim of the present study was to find out whether brain nitroxidergic system may be involved in modulation of central cardiovascular effects of arginine vasopressin (AVP) in normotensive (WKY) rats and whether its regulatory effects are altered in spontaneously hypertensive (SHR) rats. Two series of experiments were performed on conscious WKY and SHR rats instrumented with the lateral cerebral ventricle (i.c.v.) cannula and with the femoral arterial catheters. In Series 1 (10 WKY, 7 SHR rats), i.c.v. application of 2.3 nmol (0.5 microg) of N(G)-nitro-L-arginine (L-NNA), an inhibitor of NO synthesis, did not significantly affect baseline arterial blood pressure (MAP) and heart rate (HR). In WKY but not in SHR, i.c.v. administration of 5.8 nmol (1 microg) of L-arginine (L-ARG) elicited a small, significant decrease of MAP (P < 0.05) which could be reversed by i.c.v. pretreatment with L-NNA. In Series 2 (7 WKY, 8 SHR), administration of 10 pmol of AVP (10 ng) resulted in significant pressor effect in both strains; MAP increase being significantly greater in SHR than in WKY rats (P < 0.05). I.c.v. pretreatment with L-NNA significantly intensified the pressor response to centrally applied AVP both in WKY (P < 0.01) and in SHR (P < 0.01) rats; the maximum increase of blood pressure to combined administration of L-NNA and AVP being significantly greater in SHR than in WKY rats. The results indicate existence of an interaction between the central vasopressinergic and nitroxidergic system in blood pressure regulation. It is suggested that centrally released AVP increases availability of nitric oxide in the brain cardiovascular regions, whereas NO plays a compensatory role by reducing central pressor effect of AVP. Effectiveness of this compensatory mechanism is enhanced in the SHR rats.