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Review
. 2012 Jan 20:10:7.
doi: 10.1186/1741-7015-10-7.

The role of copeptin as a diagnostic and prognostic biomarker for risk stratification in the emergency department

Christian H Nickel  1 , Roland Bingisser, Nils G Morgenthaler
Affiliations
Review

The role of copeptin as a diagnostic and prognostic biomarker for risk stratification in the emergency department

Christian H Nickel et al. BMC Med. .

Abstract

The hypothalamic-pituitary-adrenal axis is activated in response to stress. One of the activated hypothalamic hormones is arginine vasopressin, a hormone involved in hemodynamics and osmoregulation. Copeptin, the C-terminal part of the arginine vasopressin precursor peptide, is a sensitive and stable surrogate marker for arginine vasopressin release. Measurement of copeptin levels has been shown to be useful in a variety of clinical scenarios, particularly as a prognostic marker in patients with acute diseases such as lower respiratory tract infection, heart disease and stroke. The measurement of copeptin levels may provide crucial information for risk stratification in a variety of clinical situations. As such, the emergency department appears to be the ideal setting for its potential use. This review summarizes the recent progress towards determining the prognostic and diagnostic value of copeptin in the emergency department.

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Figures

Figure 1
Figure 1
Cartoon of the 164-amino acid peptide precursor, preprovasopressin. Shows the signal sequence (white), AVP (dark green), neurophysin II (pale green) and copeptin (light green). Copeptin (CT-proAVP) is the C-terminal part of proAVP. Numbers indicate amino acids of the human protein. AVP: arginine vasopressin; CT-proAVP: C-terminal proAVP; signal: signal peptide.
Figure 2
Figure 2
Synthesis and release of AVP and copeptin in hypothalamus and pituitary. Pro-AVP is processed in the hypothalamus, followed by two distinct release-mechanisms for the anterior and posterior pituitary. During stress, a drop in blood pressure, or a change in osmotic pressure, AVP is released into the circulation. ACTH: adrenocorticotropic hormone; AVP: arginine vasopressin.
See this image and copyright information in PMC

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