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The Posterior Pituitary

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Principles of Endocrinology and Hormone Action

Part of the book series: Endocrinology ((ENDOCR))

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Abstract

The posterior pituitary is comprised of the end terminals of specialized hypothalamic neurons called neurohypophyseal neurons. The two hormones of the posterior pituitary, arginine vasopressin (AVP) and oxytocin (OT), are synthesized in the cell bodies of the neurohypophyseal neurons. The pre-prohormones are cleaved from the signal peptide in the endoplasmic reticulum, and the prohormones, provasopressin and pro-oxytocin, are packaged along with processing enzymes into neurosecretory granules. The neurosecretory granules are transported out of the perikaryon of the neurohypophyseal neurons via microtubules down the long axons that form the supraopticohypophyseal tract to terminate in axon terminals in the posterior pituitary. The entire unit including the magnocellular neurons in the SON and PVN, the supraopticohypophyseal tract, and the axon terminals in the posterior pituitary is called the neurohypophysis. The primary physiologic action of AVP is its function as a water-retaining hormone via activation of vasopressin V2 receptors in the principal cells of the kidney collecting duct. Disorders of AVP synthesis or secretion can lead to excessive water excretion (diabetes insipidus) or inappropriate water retention (syndrome of inappropriate antidiuretic hormone secretion). The primary physiologic action of OT is its function to stimulate milk secretion during suckling via activation of OT receptors in the breast with subsequent contraction of myoepithelial cells around the breast alveoli and ductules to eject milk. Disorders of OT synthesis or secretion can lead to inability to eject breast milk postpartum, though clinical cases have not been described in humans. Both AVP and OT are also synthesized in parvocellular hypothalamic neurons that project within the brain and regulate a variety of central nervous system functions, not all of which have been characterized.

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References

  • Adrogue HJ, Madias NE. Hypernatremia. N Engl J Med. 2000a;342(20):1493–9. Available from: PM:10816188.

    Article  CAS  PubMed  Google Scholar 

  • Adrogue HJ, Madias NE. Hyponatremia. N Engl J Med. 2000b;342(21):1581–9. Available from: PM:0010824078.

    Article  CAS  PubMed  Google Scholar 

  • Ayus JC. Diuretic-induced hyponatremia [editorial]. Arch Intern Med. 1986;146(7):1295–6. Available from: PM:0003718124.

    Article  CAS  PubMed  Google Scholar 

  • Babey M, Kopp P, Robertson GL. Familial forms of diabetes insipidus: clinical and molecular characteristics. Nat Rev Endocrinol. 2011;7(12):701–14. Available from: PM:21727914.

    Article  CAS  PubMed  Google Scholar 

  • Bartter FC, Schwartz WB. The syndrome of inappropriate secretion of antidiuretic hormone. Am J Med. 1967;42:790–806.

    Article  CAS  PubMed  Google Scholar 

  • Battison C, Andrews PJ, Graham C, Petty T. Randomized, controlled trial on the effect of a 20% mannitol solution and a 7.5% saline/6% dextran solution on increased intracranial pressure after brain injury. Crit Care Med. 2005;33(1):196–202. Available from: PM:15644669.

    Article  CAS  PubMed  Google Scholar 

  • Baylis PH, Thompson CJ. Osmoregulation of vasopressin secretion and thirst in health and disease. Clin Endocrinol (Oxf). 1988;29(5):549–76. Available from: PM:3075528.

    Article  CAS  Google Scholar 

  • Baylis PH, Thompson CJ. Diabetes insipidus and hyperosmolar syndromes. In: Becker KL, editor. Principles and practice of endocrinology and metabolism. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2001. p. 285–93.

    Google Scholar 

  • Berl T. Impact of solute intake on urine flow and water excretion. J Am Soc Nephrol. 2008;19(6):1076–8. Available from: PM:18337482.

    Article  CAS  PubMed  Google Scholar 

  • Berl T, Quittnat-Pelletier F, Verbalis JG, Schrier RW, Bichet DG, Ouyang J, Czerwiec FS. Oral tolvaptan is safe and effective in chronic hyponatremia. J Am Soc Nephrol. 2010;21(4):705–12. Available from: PM:20185637.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Bissram M, Scott FD, Liu L, Rosner MH. Risk factors for symptomatic hyponatraemia: the role of pre-existing asymptomatic hyponatraemia. Intern Med J. 2007;37(3):149–55. Available from: PM:17316332.

    Article  CAS  PubMed  Google Scholar 

  • Decaux G. The syndrome of inappropriate secretion of antidiuretic hormone (SIADH). Semin Nephrol. 2009;29(3):239–56. Available from: PM:19523572.

    Article  CAS  PubMed  Google Scholar 

  • Decaux G, Genette F. Urea for long-term treatment of syndrome of inappropriate secretion of antidiuretic hormone. Br Med J – Clin Res. 1981;283:1081–3.

    Article  CAS  Google Scholar 

  • Decaux G, Waterlot Y, Genette F, Mockel J. Treatment of the syndrome of inappropriate secretion of antidiuretic hormone with furosemide. N Engl J Med. 1981;304:329–30.

    Article  CAS  PubMed  Google Scholar 

  • Ellison DH, Berl T. Clinical practice. The syndrome of inappropriate antidiuresis. N Engl J Med. 2007;356(20):2064–72. Available from: PM:17507705.

    Article  CAS  PubMed  Google Scholar 

  • Fujiwara TM, Bichet DG. Molecular biology of hereditary diabetes insipidus. J Am Soc Nephrol. 2005;16:2836. Available from: PM:16093448.

    Article  CAS  PubMed  Google Scholar 

  • Furst H, Hallows KR, Post J, Chen S, Kotzker W, Goldfarb S, Ziyadeh FN, Neilson EG. The urine/plasma electrolyte ratio: a predictive guide to water restriction. Am J Med Sci. 2000;319(4):240–4. Available from: PM:0010768609.

    Article  CAS  PubMed  Google Scholar 

  • Goldszmidt MA, Iliescu EA. DDAVP to prevent rapid correction in hyponatremia. Clin Nephrol. 2000;53(3):226–9. Available from: PM:0010749304.

    CAS  PubMed  Google Scholar 

  • Greenberg A, Verbalis JG. Vasopressin receptor antagonists. Kidney Int. 2006;69(12):2124–30. Available from: PM:16672911.

    Article  CAS  PubMed  Google Scholar 

  • Grunfeld JP, Rossier BC. Lithium nephrotoxicity revisited. Nat Rev Nephrol. 2009;5(5):270–6. Available from: PM:19384328.

    Article  CAS  PubMed  Google Scholar 

  • Gullans SR, Verbalis JG. Control of brain volume during hyperosmolar and hypoosmolar conditions. Annu Rev Med. 1993;44:289–301.

    Article  CAS  PubMed  Google Scholar 

  • Heinbecker P, White HL. Hypothalamico-hypophyseal system and its relation to water balance in the dog. Am J Physiol. 1941;133:582–93.

    CAS  Google Scholar 

  • Hew-Butler T, Ayus JC, Kipps C, Maughan RJ, Mettler S, Meeuwisse WH, Page AJ, Reid SA, Rehrer NJ, Roberts WO, Rogers IR, Rosner MH, Siegel AJ, Speedy DB, Stuempfle KJ, Verbalis JG, Weschler LB, Wharam P. Statement of the second international exercise-associated hyponatremia consensus development conference, New Zealand, 2007. Clin J Sport Med. 2008;18(2):111–21. Available from: PM:18332684.

    Article  PubMed  Google Scholar 

  • Ishikawa S, Fujita N, Fujisawa G, Tsuboi Y, Sakuma N, Okada K, Saito T. Involvement of arginine vasopressin and renal sodium handling in pathogenesis of hyponatremia in elderly patients. Endocr J. 1996;43(1):101–8.

    Article  CAS  PubMed  Google Scholar 

  • Johnson AK, Buggy J. Periventricular preoptic-hypothalamus is vital for thirst and normal water economy. Am J Physiol. 1978;234(3):R122–9. Available from: PM:629368.

    Article  CAS  PubMed  Google Scholar 

  • Khanna A. Acquired nephrogenic diabetes insipidus. Semin Nephrol. 2006;26(3):244–8. Available from: PM:16713497.

    Article  CAS  PubMed  Google Scholar 

  • Li-Ng M, Verbalis JG. Conivaptan: evidence supporting its therapeutic use in hyponatremia. Core Evid. 2010;4:83–92. Available from: PM:20694067.

    PubMed  PubMed Central  Google Scholar 

  • Morgenthaler NG, Struck J, Jochberger S, Dunser MW. Copeptin: clinical use of a new biomarker. Trends Endocrinol Metab. 2008;19(2):43–9. Available from: PM:18291667.

    Article  CAS  PubMed  Google Scholar 

  • Oelkers W. Hyponatremia and inappropriate secretion of vasopressin (antidiuretic hormone) in patients with hypopituitarism. N Engl J Med. 1989;321:492–6.

    Article  CAS  PubMed  Google Scholar 

  • Ohnishi A, Orita Y, Okahara R, Fujihara H, Inoue T, Yamamura Y, Yabuuchi Y, Tanaka T. Potent aquaretic agent. A novel nonpeptide selective vasopressin 2 antagonist (OPC-31260) in men. J Clin Invest. 1993;92(6):2653–9. Available from: PM:8254021.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Oya S, Tsutsumi K, Ueki K, Kirino T. Reinduction of hyponatremia to treat central pontine myelinolysis. Neurology. 2001;57(10):1931–2. Available from: PM:11723299.

    Article  CAS  PubMed  Google Scholar 

  • Renneboog B, Musch W, Vandemergel X, Manto MU, Decaux G. Mild chronic hyponatremia is associated with falls, unsteadiness, and attention deficits. Am J Med. 2006;119(1):71. Available from: PM:16431193.

    Article  CAS  PubMed  Google Scholar 

  • Robertson GL. Diabetes insipidus. Endocrinol Metab Clin North Am. 1995;24(3):549–72. Available from: PM:0008575409.

    CAS  PubMed  Google Scholar 

  • Robertson GL. Regulation of arginine vasopressin in the syndrome of inappropriate antidiuresis. Am J Med. 2006;119(7 Suppl 1):S36–42. Available from: PM:16843083.

    Article  CAS  PubMed  Google Scholar 

  • Robinson AG. DDAVP in the treatment of central diabetes insipidus. N Engl J Med. 1976;294(10):507–11. Available from: PM:1250255.

    Article  CAS  PubMed  Google Scholar 

  • Robinson AG. Disorders of antidiuretic hormone secretion. J Clin Endocrinol Metab. 1985;14:55–88.

    Article  CAS  Google Scholar 

  • Robinson AG, Verbalis JG. Diabetes insipidus. Curr Ther Endocrinol Metab. 1997;6:1–7.

    CAS  PubMed  Google Scholar 

  • Robinson AG, Verbalis JG. Posterior pituitary. In: Melmed S, et al., editors. Williams textbook of endocrinology. 12th ed. Philadelphia: W.B. Saunders; 2011. p. 291–323.

    Chapter  Google Scholar 

  • Sands JM, Bichet DG. Nephrogenic diabetes insipidus. Ann Intern Med. 2006;144(3):186–94. Available from: PM:16461963.

    Article  CAS  PubMed  Google Scholar 

  • SAMSCA (tolvaptan) Prescribing Information. Otsuka America Pharmaceutical, Inc., Princeton, N.J. 07US14L-0919A, Rev. 02,2014.

    Google Scholar 

  • Schrier RW, Gross P, Gheorghiade M, Berl T, Verbalis JG, Czerwiec FS, Orlandi C. Tolvaptan, a selective oral vasopressin V2-receptor antagonist, for hyponatremia. N Engl J Med. 2006;355(20):2099–112. Available from: PM:17105757.

    Article  CAS  PubMed  Google Scholar 

  • Schwartz WB, Bennett S, Curelop S, Bartter FC. A syndrome of renal sodium loss and hyponatremia probably resulting from inappropriate secretion of antidiuretic hormone. Am J Med. 1957;23:529–42.

    Article  CAS  PubMed  Google Scholar 

  • Singer I, Rotenberg D. Demeclocycline-induced nephrogenic diabetes insipidus. In-vivo and in- vitro studies. Ann Intern Med. 1973;79(5):679–83. Available from: PM:4356453.

    Article  CAS  PubMed  Google Scholar 

  • Sofroniew MV, Weindl A, Schrell U, Wetzstein R. Immunohistochemistry of vasopressin, oxytocin and neurophysin in the hypothalamus and extrahypothalamic regions of the human and primate brain. Acta Histochem Suppl. 1981;24:79–95. Available from: PM:6785843.

    CAS  PubMed  Google Scholar 

  • Soupart A, Penninckx R, Crenier L, Stenuit A, Perier O, Decaux G. Prevention of brain demyelination in rats after excessive correction of chronic hyponatremia by serum sodium lowering. Kidney Int. 1994;45:193–200.

    Article  CAS  PubMed  Google Scholar 

  • Spasovski G, Vanholder R, Allolio B, Annane D, Ball S, Bichet D, Decaux G, Fenske W, Hoorn EJ, Ichai C, Joannidis M, Soupart A, Zietse R, Haller M, van der Veer S, Van BW, Nagler E. Clinical practice guideline on diagnosis and treatment of hyponatraemia. Nephrol Dial Transplant. 2014;29:i1. Available from: PM:24569496.

    Article  PubMed  Google Scholar 

  • Steele A, Gowrishankar M, Abrahamson S, Mazer CD, Feldman RD, Halperin ML. Postoperative hyponatremia despite near-isotonic saline infusion: a phenomenon of desalination [see comments]. Ann Intern Med. 1997;126(1):20–5.

    Article  CAS  PubMed  Google Scholar 

  • Sterns RH, Riggs JE, Schochet Jr SS. Osmotic demyelination syndrome following correction of hyponatremia. N Engl J Med. 1986;314:1535–42.

    Article  CAS  PubMed  Google Scholar 

  • Sterns RH, Cappuccio JD, Silver SM, Cohen EP. Neurologic sequelae after treatment of severe hyponatremia: a multicenter perspective. J Am Soc Nephrol. 1994;4:1522–30.

    CAS  PubMed  Google Scholar 

  • Sterns RH, Nigwekar SU, Hix JK. The treatment of hyponatremia. Semin Nephrol. 2009;29(3):282–99. Available from: PM:19523575.

    Article  CAS  PubMed  Google Scholar 

  • Swanson LW, Sawchenko PE. Paraventricular nucleus: a site for the integration of neuroendocrine and autonomic mechanisms. Neuroendocrinology. 1980;31(6):410–7. Available from: PM:6109264.

    Article  CAS  PubMed  Google Scholar 

  • Thibonnier M, Conarty DM, Preston JA, Wilkins PL, Berti-Mattera LN, Mattera R. Molecular pharmacology of human vasopressin receptors. Adv Exp Med Biol. 1998;449:251–76. Available from: PM:10026814.

    Article  CAS  PubMed  Google Scholar 

  • Thibonnier M, Coles P, Thibonnier A, Shoham M. The basic and clinical pharmacology of nonpeptide vasopressin receptor antagonists. Annu Rev Pharmacol Toxicol. 2001;41:175–202. Available from: PM:11264455.

    Article  CAS  PubMed  Google Scholar 

  • Verbalis JG. Hyponatremia and hypo-osmolar disorders. In: Greenberg A, et al., editors. Primer on kidney diseases. 5th ed. Philadelphia: Saunders Elsevier; 2009. p. 52–9.

    Chapter  Google Scholar 

  • Verbalis JG. Brain volume regulation in response to changes in osmolality. Neuroscience. 2010;168(4):862–70. Available from: PM:20417691.

    Article  CAS  PubMed  Google Scholar 

  • Verbalis JG. Disorders of water balance. In: Taal MW, et al., editors. Brenner & Rector’s the kidney. 9th ed. Philadelphia: Elsevier; 2012. p. 540–94.

    Chapter  Google Scholar 

  • Verbalis JG. The syndrome of inappropriate antidiuretic hormone secretion and other hypoosmolar disorders. In: Coffmna TM, et al., editors. Schrier’s diseases of the kidney. 9th ed. Philadelphia: Lippincott, Williams & Wilkins; 2013. p. 2012–54.

    Google Scholar 

  • Verbalis JG. Posterior pituitary. In: Goldman L, Ausiello D, editors. Cecil medicine. 25th ed. Philadelphia: Saunders Elsevier; 2016a. p. 1494–9.

    Google Scholar 

  • Verbalis JG. Disorders of water balance. In: Brenner B, editor. Brenner & Rector’s the kidney. 10th ed. Philadelphia: W.B. Saunders Elsevier; 2016b. p. 460–510.

    Google Scholar 

  • Verbalis JG, Goldsmith SR, Greenberg A, Schrier RW, Sterns RH. Hyponatremia treatment guidelines 2007: expert panel recommendations. Am J Med. 2007;120(11 Suppl 1):S1–21. Available from: PM:17981159.

    Article  CAS  PubMed  Google Scholar 

  • Zeltser D, Rosansky S, van Rensburg H, Verbalis JG, Smith N. Assessment of the efficacy and safety of intravenous conivaptan in euvolemic and hypervolemic hyponatremia. Am J Nephrol. 2007;27(5):447–57. Available from: PM:17664863.

    Article  CAS  PubMed  Google Scholar 

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Verbalis, J.G. (2018). The Posterior Pituitary. In: Belfiore, A., LeRoith, D. (eds) Principles of Endocrinology and Hormone Action. Endocrinology. Springer, Cham. https://doi.org/10.1007/978-3-319-44675-2_13

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  • DOI: https://doi.org/10.1007/978-3-319-44675-2_13

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