Health Institution Varaidin County, Medical Biochemistry Laboratory, Varazdin, Croatia.
Biochem Med (Zagreb). 2013;23(2):172-90. doi: 10.11613/bm.2013.021.
The need for faster diagnosis, more accurate prognostic assessment and treatment decisions in various diseases has lead to the investigations of new biomarkers. The hope is that this new biomarkers will enable early decision making in clinical practice. Arginine vasopressin (AVP) is one of the main hormones of the hypothalamic-pituitary-adrenal axis. Its main stimulus for secretion is hyperosmolarity, but AVP system is also stimulated by exposure of the body to endogenous stress. Reliable measurement of AVP concentration is difficult because it is subject to preanalytical and analytical errors. It is therefore not used in clinical practice. Copeptin, a 39-aminoacid glycopeptide, is a C-terminal part of the precursor pre-provasopressin (pre-proAVP). Activation of AVP system stimulates copeptin secretion into the circulation from the posterior pituitary gland in equimolar amounts with AVP. Therefore, copeptin directly reflects AVP concentration and can be used as surrogate biomarker of AVP secretion. Even mild to moderate stress situations contribute to release of copeptin. These reasons have lead to a handful of research on copeptin in various diseases. This review summarizes the current achievements in the research of copeptin as a diagnostic and prognostic marker and also discusses its association in different disease processes.
在各种疾病中，对更快的诊断、更准确的预后评估和治疗决策的需求，导致了对新生物标志物的研究。希望这些新的生物标志物将能够在临床实践中实现早期决策。精氨酸加压素（AVP）是下丘脑-垂体-肾上腺轴的主要激素之一。其分泌的主要刺激因素是高渗性，但 AVP 系统也受到身体对内源性应激的刺激。AVP 浓度的可靠测量很困难，因为它受到分析前和分析误差的影响。因此，它未在临床实践中使用。copeptin 是一种 39 个氨基酸的糖肽，是前脑啡肽原（pre-proAVP）的 C 端部分。AVP 系统的激活刺激后叶垂体以与 AVP 等量的方式将 copeptin 分泌到循环中。因此，copeptin 直接反映 AVP 浓度，可作为 AVP 分泌的替代生物标志物。即使是轻度到中度的应激情况也会导致 copeptin 的释放。这些原因导致了对 copeptin 在各种疾病中的研究。这篇综述总结了 copeptin 作为诊断和预后标志物的研究现状，并讨论了其在不同疾病过程中的相关性。
