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A Preclinical Model of Exertional Heat Stroke in Mice
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Copeptin reflects physiological strain during thermal stress.

Michael John Stacey1,2, Simon K Delves3, Sophie E Britland3

  • 1Department of Surgery and Cancer, Imperial College London, Care of General Intensive Care Unit, Hammersmith Hospital Campus, Du Cane Road, London, W12 0HS, UK. m.stacey13@ic.ac.uk.

European Journal of Applied Physiology
|October 28, 2017
PubMed
Summary

Plasma copeptin levels increased with heat stress, reflecting core body temperature (Tc) responses more closely than other markers. This suggests copeptin may help prevent heat-related illnesses.

Keywords:
Acute kidney injuryArginine vasopressinCortisolDehydrationHeat illnessNormetanephrine

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Area of Science:

  • Physiology
  • Environmental Health
  • Biomarkers

Background:

  • Guidelines recommend limiting core body temperature (Tc) to ≤38°C during thermal stress to prevent heat-related illnesses.
  • Copeptin, a marker for arginine vasopressin secretion, may indicate fluid balance, thermal strain, and health risks.
  • Previous research suggests copeptin could be a valuable indicator of physiological strain in heat-exposed individuals.

Purpose of the Study:

  • To investigate if plasma copeptin levels rise with dehydration during occupational heat stress.
  • To determine if copeptin changes correlate with sympathoadrenal activation, reduced glomerular filtration, and core body temperature (Tc) responses.
  • To assess copeptin's utility as a surrogate marker for physiological strain in heat exposure.

Main Methods:

  • Fifteen British Army volunteers in East Africa underwent a 3.5-hour simulated combat assault at 27°C.
  • Core body temperature (Tc) was monitored via radiotelemetry to classify participants into groups with Tc >38°C or ≤38°C.
  • Blood samples were collected pre- and post-exposure to measure copeptin, cortisol, free normetanephrine, osmolality, and creatinine.

Main Results:

  • Plasma copeptin significantly increased from pre- to post-exposure (10.0 ± 6.3 to 16.7 ± 9.6 pmol/L).
  • Copeptin correlated strongly with osmolality (r=0.70, P=0.004), despite no significant increase in osmolality.
  • Volunteers with Tc >38°C showed significantly greater elevations in copeptin and creatinine compared to those with Tc ≤38°C.

Conclusions:

  • Changes in plasma copeptin closely reflected core body temperature (Tc) responses during heat stress.
  • Copeptin's relationship with tonicity and kidney function may explain its sensitivity to thermal strain.
  • Copeptin assay is a promising tool for assessing integrated physiological strain and informing strategies to prevent heat-related illnesses.