Structural basis of tolvaptan binding to the vasopressin V receptor.

The vasopressin V receptor (VR) is a validated therapeutic target for autosomal dominant polycystic kidney disease (ADPKD), with tolvaptan being the first FDA-approved antagonist. Herein, we used Gaussian accelerated molecular dynamics simulations to investigate the spontaneous binding of tolvaptan to both active and inactive VR conformations at the atomic-level. Overall, the binding process consists of two stages.