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Editorial
. 2019 Jul;30(7):1141-1143.
doi: 10.1681/ASN.2019050472. Epub 2019 Jun 19.

A "Set Point" for Water Homeostasis Disturbed with Altered Kidney Transplantation Outcome

Daniel G Bichet  1
Affiliations
Editorial

A "Set Point" for Water Homeostasis Disturbed with Altered Kidney Transplantation Outcome

Daniel G Bichet. J Am Soc Nephrol. 2019 Jul.
No abstract available

Keywords: median pre-optic nucleus; thirst; water homeostasis; water load.

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Figures

Figure 1.
Figure 1.
It is proposed here, in this schematic representation of central hypothalamic pathways, that glutamatergic neurons in the subfornical organ, SFONos1 neurons that promote drinking and directly monitor blood osmolarity, are suppressed in patients with a better outcome, during the waterload experiments reported by Mazloum et al. Following the detection of water in the mouth and its gulping, there is a gut-to-brain signal: the osmolarity of the ingested fluid is perceived early in the digestive tract, probably in the small intestine or hepatic portal circulation, relayed by the vagus nerve, and inhibits SFONos1 neurons well before any change in blood osmolality perceived by osmoreceptor cells. MnPOGLP1R →SFOnNOS form an inhibitory circuit where MnPOGLP1R neurons are sensing volume in the oropharyngeal and osmolarity in the gastrointestinal tract (represented schematically by blue arrows). There is an integrated central representation of fluid balance at the level of individual MnPO neurons, which use this information to dynamically control drinking behavior and vasopressin secretion in real time. GI, gastrointestinal; GLP1R, glucagon-like peptide 1 receptor; nNOS, nitric oxide synthase; OVLT, organum vasculosum of the lamina terminalis; PP, posterior pituitary; PVN, paraventricular hypothalamic nucleus; SFO, subfornical organ; SON, supraoptic nucleus. Figure modified from extended data from figure 10 of reference 4 and figure 2 of reference 14, with permission.
See this image and copyright information in PMC

Comment on

  • Osmoregulation Performance and Kidney Transplant Outcome.
    Mazloum M, Jouffroy J, Brazier F, Legendre C, Neuraz A, Garcelon N, Prié D, Anglicheau D, Bienaimé F. Mazloum M, et al. J Am Soc Nephrol. 2019 Jul;30(7):1282-1293. doi: 10.1681/ASN.2018121269. Epub 2019 Jun 19. J Am Soc Nephrol. 2019. PMID: 31217325 Free PMC article.

References

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