Lu H A Jenny, He Jinzhao
Program in Membrane Biology, Division of Nephrology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
State Key Laboratory of Biomembrane and Membrane Biotechnology, Tsinghua University-Peking University Joint Center for Life Sciences, School of Life Sciences, Tsinghua University, Beijing, China.
Adv Exp Med Biol. 2023;1398:267-279. doi: 10.1007/978-981-19-7415-1_18.
Disruption of water and electrolyte balance is frequently encountered in clinical medicine. Regulating water metabolism is critically important. Diabetes insipidus (DI) presented with excessive water loss from the kidney is a major disorder of water metabolism. To understanding the molecular and cellular mechanisms and pathophysiology of DI and rationales of clinical management of DI is important for both research and clinical practice. This chapter will first review various forms of DI focusing on central diabetes insipidus (CDI) and nephrogenic diabetes insipidus (NDI). This is followed by a discussion of regulatory mechanisms underlying CDI and NDI, with a focus on the regulatory axis of vasopressin, vasopressin receptor 2 (V2R) and the water channel molecule, aquaporin 2 (AQP2). The clinical manifestation, diagnosis, and management of various forms of DI will also be discussed with highlights of some of the latest therapeutic strategies that are developed from in vitro experiments and animal studies.
水和电解质平衡紊乱在临床医学中屡见不鲜。调节水代谢至关重要。尿崩症（DI）表现为肾脏过度失水，是水代谢的一种主要紊乱疾病。了解尿崩症的分子和细胞机制、病理生理学以及临床管理的基本原理，对研究和临床实践都很重要。本章将首先回顾各种形式的尿崩症，重点是中枢性尿崩症（CDI）和肾性尿崩症（NDI）。随后将讨论CDI和NDI的调节机制，重点是抗利尿激素、抗利尿激素受体2（V2R）和水通道分子水通道蛋白2（AQP2）的调节轴。还将讨论各种形式尿崩症的临床表现、诊断和管理，并突出一些从体外实验和动物研究中开发的最新治疗策略。
