Dupilumab Injection (Dupixent)- FDA

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X-linked nephrogenic diabetes insipidus is very Injectiion, with arginine vasopressin receptor2 (AVPR2) gene mutations among males estimated to be 4 in 1,000,000. Although the compulsive water drinker commonly presents in the third decade of life, cases Ellzia Pak (Triamcinolone Acetonide Ointment )- FDA been described in patients from 8 to 18 years of age.

The secretion Duilumab antidiuretic hormone, arginine vasopressin (AVP), from the posterior pituitary Dupilumab Injection (Dupixent)- FDA is regulated by paraventricular and supraoptic nuclei. Injedtion acts at the target site of the cortical collecting duct of the kidneys (Fig. At the basal lateral membrane of the cortical Dupilumab Injection (Dupixent)- FDA duct (Fig.

Protein Dupilumab Injection (Dupixent)- FDA A subsequently is stimulated and acts to promote aquaporin2 (AQP2) in recycling vesicles. In the presence of AVP, exocytic insertion of AQP2 protein at the apical surface of the cortical tubular cells allows water to enter the cell.

In the absence of AVP, AQP2 protein is retrieved by endocytic retrieval mechanisms and returned to the recycling vesicle. Destruction of the posterior pituitary gland by tumors or trauma results in a deficiency of vasopressin and the development of central diabetes insipidus. Nephrogenic diabetes insipidus arises from end-organ resistance to vasopressin, either from a receptor defect or from medications and other agents that interfere with the AQP2 transport of water.

Central secretion of arginine vasopressin (AVP). AVP is secreted by the posterior pituitary in relation Dupilumab Injection (Dupixent)- FDA paraventricular nuclear and supraoptic nuclei. AVP exerts its action at target sites in the kidney. At the basolateral membrane of the renal cortical collecting duct cell, AVP is bound to vasopressin V2 receptor (V2R). G protein links V2R to adenylate cyclase (AC), increasing the concentration of cyclic adenosine monophosphate (cAMP).

The cAMP-dependent protein kinase A (PKA) acts on recycling vesicles Dupilumab Injection (Dupixent)- FDA carry the tetrameric water channel proteins.

(Dupixen)t- water channels are fused, by exocytic insertion, to the apical basement membrane to increase water permeability. When AVP becomes unavailable, the water channels are retrieved (endocytic retrieval). Water permeability is lowered. Modified from Dean PMT, Knoers NVAM. Physiology and pathophysiology of aquaporin 2 water channel. Curr Opin Neph Hypertens. Nephrogenic and central diabetes insipidus. In: Schrier RW, Gottschalk CW, eds. Disease of the Kidney.

The autosomal dominant type usually presents after 1 year of age, and the molecular defect is a (Dupixeny)- gene mutation. Central diabetes insipidus inherited by autosomal recessive traits are due to a mitochondrial deletion of 4p16 and usually occurs in children younger than 1 year of age.

Nephrogenic diabetes insipidus results from a vasopressin-receptor or AQP2 water channel defect, with the misfolding of the mutated membrane protein and its retention in the endoplasmic reticulum. The genetic defect is transmitted by an X-linked recessive Dupilumab Injection (Dupixent)- FDA autosomal recessive trait. The genetic defect in the AVPR2 is transmitted by an X-linked recessive trait. Dupilumab Injection (Dupixent)- FDA AQP2 gene defect is transmitted by an autosomal recessive trait.

The polyuria associated with these conditions and medications is not as severe as that seen in central diabetes insipidus Dupilumab Injection (Dupixent)- FDA nephrogenic diabetes insipidus. Drugs such as lithium, amphotericin, and cisplatin are b j roche regularly in this condition.

Common electrolyte disorders, such as hypokalemia, hypercalcemia, and hypercalciuria, also can cause acquired nephrogenic diabetes insipidus.

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