Natural Peptide Toxins as an Option for Renewed Treatment of Type 2 Vasopressin Receptor-Related Diseases

SIMPLE SUMMARY: The type 2 vasopressin receptor is a perfect representative of therapeutic targets that are underexploited due to the lack of safe and effective drugs. This receptor is well-known in terms of physiological roles and tissue expression. Both its activation and blockage are associated with several diseases affecting millions of untreated patients. Despite this, only one agonist and virtually one antagonist are currently available but used with many concerns. It is clear that medicinal chemistry has failed to develop good drugs, leaving millions of patients without treatment. Nature remains the primary supplier of new drugs. A natural resource, animal venoms, has clearly not been sufficiently explored and exploited. These venoms are composed of hundreds of toxins, which have evolved over millions of years to be very often selective and affine to their target, making venoms reservoirs of drug candidates. Animal toxins active on the vasopressin type 2 receptor are reviewed herein, and their potential therapeutic interest is highlighted. ABSTRACT: The type 2 vasopressin receptor (V2R) is expressed in the kidneys, and it is the keystone of water homeostasis. Under the control of the antidiuretic hormone vasopressin, the V2R ensures vital functions, and any disturbance has dramatic consequences. Despite decades of research to develop drugs capable of activating or blocking V2R function to meet real medical needs, only one agonist and one antagonist are virtually used today. These two drugs cover only a small portion of patients’ needs, leaving millions of patients without treatment. Natural peptide toxins known to act selectively and at low doses on their receptor target could offer new therapeutic options.