Intravenously injected CDP-choline increases blood pressure and reverses hypotension in haemorrhagic shock: effect is mediated by central cholinergic activation
Related Experiment Video
Updated: Sep 26, 2026

Paired Cisterna Magna Nanoinjection and Laser Speckle Contrast Imaging Assay to Study Cerebral Blood Flow Regulation In Vivo
Published on: July 8, 2025
Vahide Savci1, Gokhan Goktalay, Mehmet Cansev
1Department of Pharmacology and Clinical Pharmacology, Uludag University Medical Faculty, Görükle, Bursa, Turkey. vsavci@uludag.edu.tr
Insights
Cytidine-5'-diphosphate choline (CDP-choline) administration increases blood pressure and reverses hemorrhagic shock hypotension. This effect is mediated by central nicotinic cholinergic mechanisms and involves increased plasma catecholamines and vasopressin.
Area of Science:
- Pharmacology
- Neuroscience
- Cardiovascular Physiology
Background:
- Cytidine-5 -diphosphate choline (CDP-choline) is a precursor for phospholipid synthesis.
- Its effects on blood pressure regulation, particularly in shock states, require elucidation.
Purpose of the Study:
- To investigate the cardiovascular effects of CDP-choline.
- To determine the underlying mechanisms of CDP-choline-induced pressor responses.
Main Methods:
- Intravenous administration of CDP-choline, choline, and cytidine in normal and hypotensive rats.
- Intracerebroventricular administration of hemicholinium-3, atropine, and mecamylamine.
- Measurement of blood pressure, plasma catecholamines, vasopressin, and renin activity.
- Pharmacological blockade using prazosin and a vasopressin V(1) receptor antagonist.
Main Results:
- CDP-choline increased blood pressure in normal rats and reversed hypotension in hemorrhagic shock.
- Choline administration decreased blood pressure, while cytidine had no effect.
- Central nicotinic cholinergic mechanisms, increased plasma choline, catecholamines, and vasopressin mediated the pressor effect.
- Prazosin and vasopressin V(1) receptor antagonism attenuated or blocked the pressor response.
Conclusions:
- Intravenous CDP-choline exerts a pressor effect and improves hemodynamic status in hemorrhagic shock.
- The mechanism involves central cholinergic activation and subsequent release of catecholamines and vasopressin.
- CDP-choline represents a potential therapeutic agent for hypotensive conditions.
Abstract:
Intravenous (i.v.) administration of cytidine-5'-diphosphate choline (CDP-choline) (100, 250 and 500 mg/kg) increased blood pressure in normal rats and reversed hypotension in haemorrhagic shock. Choline (54 mg/kg; i.v.), at the dose equimolar to 250 mg/kg CDP-choline decreased blood pressure of rats in both conditions and caused the death of all hypotensive animals within 2-5 min. Equimolar dose of cytidine (124 mg/kg; i.v.) did not change cardiovascular parameters. Choline levels in plasma, lateral cerebral ventricle and hypothalamus increased after CDP-choline administration. Intracerebroventricular (i.c.v.) hemicholinium-3 pretreatment (20 microg), greatly attenuated the pressor effect of CDP-choline in both conditions. Atropine pretreatment (10 microg; i.c.v.) did not change the pressor effect of CDP-choline while mecamylamine (50 microg; i.c.v.) abolished the pressor response to drug. Besides, acetylcholine (1 micromol; i.c.v.) produced similar increases in blood pressure in normal and hypotensive conditions to that observed in CDP-choline given rats. CDP-choline (250 mg/kg; i.v.) increased plasma catecholamines and vasopressin levels but not plasma renin activity. Pretreatment of rats with either prazosin (0.5 mg/kg; i.v.) or vasopressin V(1) receptor antagonist, [beta-mercapto,beta,beta-cyclopentamethylenepropionyl(1),O-Me-Tyr(2)-Arg(8)]vasopressin (10 microg/kg; i.v.), attenuated the pressor response to CDP-choline while simultaneous administration of these antagonists before CDP-choline injection completely blocked the pressor effect. Results show that i.v. CDP-choline increases blood pressure and reverses hypotension in haemorrhagic shock. Activation of central nicotinic cholinergic mechanisms by the increases in plasma and brain choline concentrations appears to be involved in the pressor effect of this drug. Moreover, the increases in plasma catecholamines and vasopressin levels mediate these effects.
Related Concept Videos
Direct-Acting Cholinergic Agonists: Pharmacokinetics
Indirect-Acting Cholinergic Agonists: Pharmacological Actions
At the neuromuscular junction, these agents work by inhibiting the breakdown of acetylcholine, allowing it to remain bound to the receptor and bind to nearby receptors. This process leads to repetitive firing of the endplate, causing muscle...
Depolarizing Blockers: Pharmocokinetics
Blood Pressure Imbalances and Circulatory Shock
Blood Pressure: Hypertension and Hypotension
Normal blood pressure is 120/80 mm Hg. Elevated blood pressure is 120-129/under 80 mm Hg. Hypertension, warranting treatment at 130/80 mm Hg, is often asymptomatic and can lead to severe cardiovascular events, aneurysms, peripheral arterial disease, chronic renal disease, or cardiac...
Anticholinesterase Agents: Poisoning and Treatment
Irreversible agents form a strong bond with the cholinesterase enzyme, making it inactive. The breakdown of the phosphorylated enzyme is slower than the...
Antihypertensive Drugs: Vasodilators

