Key result
Carbamazepine increased water absorption and AQP2 expression in the rat inner medullary collecting duct, decreasing urinary volume and increasing osmolality in lithium-induced diabetes insipidus.
Why the study?
Does carbamazepine increase water absorption and AQP2 expression in rat inner medullary collecting ducts?
Does carbamazepine increase water absorption and AQP2 expression in rat inner medullary collecting ducts?
Carbamazepine induces kidney water absorption by increasing aquaporin 2 expression, explaining its potential to cause hyponatremia and its utility in treating lithium-induced diabetes insipidus.
Answers are grounded in this paper and cite their sources.
Hypothesis-generating for carbamazepine in lithium-induced diabetes insipidus; leaves open translation from rat models to human therapy.
BACKGROUND: Carbamazepine (Carba) is an anticonvulsant and psychotropic drug used widely for the treatment of intellectual disability and severe pains, but the incidence of hyponatremia is a common related occurrence. This hyponatremia is frequently attributed to a SIADH induced by this drug. It is also known that Carba is used to decrease the urinary volume in Diabetes Insipidus (DI) because it has an antidiuretic effect. Lithium (Li) is one of the most important drugs used to treat bipolar mood disorders. However Li has the undesirable capacity to induce DI. Nowadays, the association of these drugs is used in the treatment of patients with psychiatric and neurological problems. METHODS: In vivo and in vitro (microperfusion) experiments were developed to investigate the effect of Carba in the rat Inner Medullary Collecting Duct (IMCD). RESULTS: The results revealed that Carba was able to stimulate the V2 vasopressin receptor-Protein G complex increasing the (Pf) and water absorption. In vivo studies showed that in rats with lithium-induced DI, Carba decreased the urinary volume and increased the urinary osmolality. AQP2 expression was increased both in normal IMCD incubated with Carba and in IMCD from lithium-induced DI after Carba addition to the diet, when compared with the control. CONCLUSION: These results showed that the hyponatremia observed in patients using this anticonvulsant drug, at least in part, is due to the Carba capacity to increase IMCD's Pf and that the Lithium-Carbamazepine association is beneficial to the patient.
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Bragança et al. (2010) studied Lithium-induced Diabetes Insipidus (animal model). Carbamazepine vs. Control was evaluated on Water absorption, urinary volume, urinary osmolality, and AQP2 expression. Carbamazepine increased water absorption and AQP2 expression in the rat inner medullary collecting duct, decreasing urinary volume and increasing osmolality in lithium-induced diabetes insipidus.
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