Vasoactive intestinal peptide

Summary

Vasoactive intestinal peptide (VIP) is an endogenous 28-amino acid neuropeptide with potent vasodilatory, bronchodilatory, immunomodulatory, and secretory effects. It is widely distributed in the nervous system and gastrointestinal tract. Investigational uses include pulmonary arterial hypertension, inflammatory conditions, and as a research tool for receptor pharmacology.

Mechanism of Action

Binds VPAC1 and VPAC2 G-protein-coupled receptors, activating adenylyl cyclase and increasing intracellular cAMP; produces smooth muscle relaxation, vasodilation, modulation of immune responses, and stimulation of secretion from the pancreas and gut.

Routes of Administration

Goals & Uses

• Erectile dysfunctionSexual HealthModerate
• Immunomodulation / autoimmune diseaseImmunologyLow
• Acute Respiratory Distress Syndrome (ARDS)RespiratoryModerate
• Inflammatory bowel diseaseGastroenterologyLow
• Bronchospasm / asthmaPulmonaryLow
• Pulmonary arterial hypertensionCardiovascular / PulmonaryModerate

Contraindications

• Known hypersensitivity to VIP or excipientsAllergyHigh
• VIPoma / known VIP-secreting tumorOncology / EndocrinologyModerate
• Severe hypotensionCardiovascularHigh

Adverse Effects

• Nausea / gastrointestinal discomfortGastrointestinalUncommon
• Facial flushingCardiovascular/DermatologicCommon
• Injection site reactionsLocalCommon
• HypotensionCardiovascularCommonLow blood pressure
• TachycardiaCardiovascularCommonAbnormally fast heart rate
• Bronchospasm (paradoxical, inhalation route)PulmonaryRare

Drug Interactions

• Antihypertensive agentsModerate
• Beta-blockersLow
• Phosphodiesterase-5 inhibitors (e.g., sildenafil)Moderate

Population Constraints

• PregnancyReproductive SafetyRelative
• Pediatric patientsAgeRelative
• Elderly patientsAgeRelative
• Renal or hepatic impairmentOrgan DysfunctionRelative

Regulatory Status

• European UnionInvestigationalNo EMA-approved product. Research use only.
• United StatesInvestigationalAviptadil (synthetic VIP) received FDA Breakthrough Therapy designation for ARDS/COVID-19. No approved indications for native VIP. IND studies ongoing.
• United KingdomInvestigationalNo MHRA-approved indication. Under investigation in clinical trials.

No FDA- or EMA-approved therapeutic product based on native VIP exists. Aviptadil (a synthetic form of VIP) has received FDA Breakthrough Therapy designation and has been investigated under IND. Various VIP analogs and receptor agonists are in early-phase trials.

Evidence & Sources

No sources recorded yet.