Influence of the emetic reflex on vasopressin release in man

J. W. Rowe, R. L. Shelton, J. H. Helderman, R. E. Vestal, G. L. Robertson

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258 Scopus citations

Abstract

The mechanisms underlying the frequent association of nausea and vomiting with elevations of plasma vasopressin (PAVP) were studied in man and rat. After oral water loads (N = 16), plasma osmolality fell in all human subjects and was associated with a decline in PAVP in 14 asymptomatic human subjects. In 2 human subjects, nausea occurred and was associated with increases in PAVP, without changes in blood pressure. During ethanol infusion (N = 28), PAVP was suppressed unless nausea supervened. In 4 nauseated human subjects, PAVP escaped from ethanol inhibition and rose to levels 10 times basal, despite the absence of hemodynamic changes. Apomorphine, a potent dopamine agonist and emetic agent, was administered to human volunteers in doses of 7 to 24 μg/kg. There was no increase in PAVP in 3 human subjects who remained asymptomatic (7 to 16 μg/kg). Ten human subjects experienced nausea after 16 μg/kg, which was followed shortly by marked increases in PAVP. Emesis occurred in 5 human subjects given 16 to 24 μg/kg, and was followed by PAVP levels similar to those seen with nausea alone. In 7 human subjects from the nausea group, the repeat study (16 μg/kg) after pretreatment with dopamine antagonist (haloperidol, N = 4; fluphenazine, N = 3) resulted in complete blockage of apomorphine-induced AVP release. In rats, which lack an emetic reflex, apomorphine in doses of 200 μg/kg induced only slight increases in PAVP when compared to the response to 16 μg/kg in man. These studies indicate that stimulation of the emetic reflex results in AVP-release in man. Nausea-mediated AVP release supervenes over concomitant osmolar or pharmacologic (ethanol) inhibition.

Original languageEnglish
Pages (from-to)729-735
Number of pages7
JournalKidney International
Volume16
Issue number6
DOIs
StatePublished - 1979
Externally publishedYes

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