Document Detail


Octreotide inhibition of flushing and colonic motor dysfunction in carcinoid syndrome.
MedLine Citation:
PMID:  9399764     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Previous studies showed increased plasma motilin and substance P concentrations and accelerated motor function in the small bowel and colon in patients with carcinoid diarrhea. Octreotide is beneficial in patients with carcinoid syndrome. Our hypothesis was that octreotide inhibits accelerated motility and gut neuropeptides in carcinoid syndrome. METHODS: In 12 patients with metastatic carcinoid syndrome, we investigated the effect of octreotide 50 microg s.c. t.i.d (n = 6) or placebo (n = 6) on postprandial symptoms, GI transit, colonic motility, and circulating levels of selected circulating peptides and amines. RESULTS: Octreotide reduced postprandial flushing (p = 0.03) but not pain. Octreotide significantly retarded overall colonic transit and proximal colonic emptying (p < 0.05); it tended to prolong small bowel transit time (p = 0.13) and to reduce postprandial colonic tone (p = 0.08) compared with placebo. Octreotide also reduced circulating levels of peptide YY, neurotensin, vasoactive intestinal polypeptide, and substance P but had no effect on plasma motilin, neuropeptide Y, calcitonin gene-related peptide, or histamine after meal ingestion. CONCLUSION: Octreotide ameliorates gut motor dysfunctions that characterize carcinoid diarrhea; the potential role of specific antagonism of serotonin, substance P, and vasoactive intestinal polypeptide alone or in combination with agents that inhibit their release in carcinoid diarrhea deserves further study.
Authors:
S B Saslow; M D O'Brien; M Camilleri; M von der Ohe; H A Homburger; G G Klee; H C Pitot; J Rubin
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  92     ISSN:  0002-9270     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  1997 Dec 
Date Detail:
Created Date:  1997-12-29     Completed Date:  1997-12-29     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  2250-6     Citation Subset:  IM    
Affiliation:
Department of Laboratory Medicine and Pathology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Antineoplastic Agents, Hormonal / administration & dosage,  therapeutic use*
Calcitonin Gene-Related Peptide / blood
Colon / drug effects
Colonic Diseases / drug therapy*
Diarrhea / drug therapy
Digestion / drug effects
Double-Blind Method
Female
Flushing / drug therapy*
Gastrointestinal Agents / administration & dosage,  therapeutic use*
Gastrointestinal Motility / drug effects*
Gastrointestinal Transit / drug effects
Histamine / blood
Humans
Intestine, Small / drug effects
Male
Malignant Carcinoid Syndrome / blood,  drug therapy*
Middle Aged
Motilin / blood
Neuropeptide Y / blood
Neuropeptides / antagonists & inhibitors
Neurotensin / antagonists & inhibitors,  blood
Octreotide / administration & dosage,  therapeutic use*
Peptide YY / antagonists & inhibitors,  blood
Placebos
Serotonin Antagonists / blood
Substance P / antagonists & inhibitors,  blood
Vasoactive Intestinal Peptide / antagonists & inhibitors,  blood
Grant Support
ID/Acronym/Agency:
585//PHS HHS
Chemical
Reg. No./Substance:
0/Antineoplastic Agents, Hormonal; 0/Gastrointestinal Agents; 0/Neuropeptide Y; 0/Neuropeptides; 0/Placebos; 0/Serotonin Antagonists; 106388-42-5/Peptide YY; 33507-63-0/Substance P; 37221-79-7/Vasoactive Intestinal Peptide; 39379-15-2/Neurotensin; 51-45-6/Histamine; 52906-92-0/Motilin; 83150-76-9/Octreotide; 83652-28-2/Calcitonin Gene-Related Peptide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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