Arginine Vasopressin Vx-Antagonist and Atrial Natriuretic Peptide Reduce Hemorrhagic Brain Edema in Rats

Background and Purpose: Injection of arginine vasopressin into the cerebral ventricles in animals with brain injury increased brain water, whereas injection of atrial natriuretic peptide reduced water content. Therefore, to determine the role of endogenous arginine vasopressin in brain edema, we attempted to inhibit edema from a hemorrhagic lesion with an arginine vasopressin Vt receptor antagonist or atrial natriuretic peptide. Methods: Adult Sprague-Dawley rats with hemorrhages induced by 0.4 IU bacterial collagenase were treated with 75 ng (n=9) or 8 jug (n=9) of the vasopressin Vi receptor antagonist </(CH2)sTyr(Me)Arg, 3.2 ftg (n=4) atrial natriuretic peptide injected intracerebrally, or 5 itg/kg per hour (n=7) atrial natriuretic peptide intraperitoneally. They were compared with control groups injected with 0.4 IU collagenase only. Brain water and electrolytes were measured 24 hours later. Brain uptake of [C] sucrose was measured 30 minutes after lesions were induced by 0.4 IU collagenase alone (n=5) or after collagenase injection and 50 /tg/kg per hour («=5) atrial natriuretic peptide injected intravenously. Results: The arginine vasopressin V, receptor antagonist and atrial natriuretic peptide significantly (/?<0.05) reduced water and sodium contents in the posterior edematous regions. Brain uptake of [C] sucrose was significantly reduced by intravenous atrial natriuretic peptide. Conclusions: Antagonists to arginine vasopressin V, receptors and atrial natriuretic peptide both significantly reduce hemorrhagic brain edema, and atrial natriuretic peptide appears to protect the blood-brain barrier. (Stroke 1992;23:1767-1774)