Regulation of Aquaporin-2 by Traditional Chinese Medicine in Water Balance Disorders: A Literature Review

Yifan Chang¹Lu Liu¹Xiaodong Xu²Shiqiang Zhang^1,2*

• ¹Heilongjiang University of Chinese Medicine, Harbin, China
• ²Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine, Cangzhou, Hebei Province, China

Aquaporin-2 (AQP2) is a critical protein involved in water metabolism, primarily located in the renal collecting duct apical plasma membrane and intracellular vesicles, regulating the movement of water into and out of cells. It plays a pivotal role in maintaining fluid balance, and its dysregulation is associated with conditions such as hypertension and heart failure, which contribute to cardiovascular disease progression. As an emerging therapeutic target, AQP2 has garnered significant attention. Traditional Chinese Medicine (TCM) has demonstrated efficacy in treating water balance disorders, although its underlying mechanisms remain elusive. The discovery of AQP2 and its association with water metabolism provides an opportunity for TCM to explore these mechanisms more intuitively. This review integrates TCM formulas, single herbs, and active constituents, linking them to AQP2 regulation across the kidney, heart, liver, inner ear, and uterus—with an emphasis on the AVP–V2R–AQP2 axis—while distinguishing short-versus long-term regulation and highlighting cardiovascular applications. This review synthesizes current evidence from experimental and limited clinical studies, highlights the regulatory effects of TCM on AQP2 in various organ systems, and identifies key research gaps to guide future translational and clinical investigations.