Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UNIPROT:P61278 (somatostatin)
22,083 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Hormonally active neuroendocrine tumors may easily be diagnosed by elevated serum levels of their specific peptides and hormonal products, but there are no reliable markers for neuroendocrine tumors without hormonal activity. Chromogranin A (CgA), a secretory protein of neuroendocrine cells, has recently been characterized as a valuable tissue marker in hormonally active and non-functioning neuroendocrine tumors. This study analyzes the role of CgA as a serum marker for different neuroendocrine tumors. Thirty-three patients with neuroendocrine tumors of the stomach (n = 7), the ileum (n = 18), and the pancreas (n = 8) were investigated. Serum CgA levels were analyzed by radioimmunoassay at the time of diagnosis and during follow-up under different therapeutic regimens. Serum CgA was elevated in 30 (91%) patients. Mean CgA serum levels varied with tumor location (pancreas: 7068 +/- 3008 ng/ml, ileum: 5381 +/- 1740 ng/ml, stomach: 529 +/- 179 ng/ml, x +/- SEM ng/ml) but did not differ between functioning and non-functioning tumors. Eight of 10 patients treated with either somatostatin or interferon-alpha showed changes of CgA concentrations corresponding to tumor growth. We conclude that CgA is a useful broad-spectrum tumor marker in gastroenteropancreatic neuroendocrine tumors. Its determination is especially recommended in tumors without hormonal activity.
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PMID:Serum chromogranin A in the diagnosis and follow-up of neuroendocrine tumors of the gastroenteropancreatic tract. 141 39

The main advances in the management of carcinoid and gastrointestinal neuroendocrine tumors have been in the areas of imaging and therapy. New techniques have been developed to detect and identify the sites of tumor so that correct therapeutic decisions can be made. Although surgery remains the mainstay of treatment of localized and some cases of advanced disease, the use of biologic agents and new drugs has proven valuable in those patients in whom surgery is not indicated. These include interferon-alpha, the somatostatin analogue octreotide, omeprazole. Different methods of delivery have been investigated with mixed success. Future progress in the understanding and management of neuroendocrine tumors is likely to be slow due to their rarity and long natural history.
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PMID:Recent advances in carcinoids and gastrointestinal neuroendocrine tumors. 204 91

Neuroendocrine gut and pancreatic tumors have over the years presented a therapeutic challenge. The patients present with a wide range of clinical symptoms related to hormone production that can sometimes be easily managed but are sometimes life threatening. The most frequent clinical symptom related to endocrine gut tumors is the carcinoid syndrome, with flushing, diarrhea, bronchoconstriction, and right heart failure. Until the middle of the 1980s, when a patient was not cured by surgery, very little could be offered except chemotherapy. Biotherapy has revolutionized the treatment of malignant neuroendocrine gut and pancreatic tumors, in which both interferon-alpha and somatostatin analogues improved the quality of life for these patients and possibly also increased survival. Chemotherapy, with response rates of 40% to 60% in endocrine pancreatic tumors, is still first-line treatment in this group of patients, whereas in patients with carcinoids of the gut, no beneficial value of chemotherapy so far has been noticed. Both interferon-alpha and somatostatin analogues provide biochemical responses in 40% to 70% of patients with carcinoid tumors, whereas significant tumor reduction is only noticed in a few cases. Development of biotherapy is just at its beginning, and in the future, when we have learned more about tumor biology and mechanisms of action of these treatments, even better therapeutic results might be encountered. Combinations of biotherapy with chemotherapy as well as combinations of different biotherapies are now under clinical investigation.
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PMID:Chemotherapy and biotherapy in neuroendocrine tumors. 809 14

Pancreatic polypeptidioma, a pancreatic endocrine tumor, is an extremely uncommon disease and its clinical features and responses to therapy are not well known. We present a 33-year-old woman with disseminated pancreatic polypeptidioma, who subsequently showed various signs and symptoms of metastases, including bone pain, cranial nerve palsy, spinal block, and hematuria, and died 22 months after the presentation. Responses to various therapeutic regimens including hepatic arterial embolization, radiation therapy, systemic chemotherapy, and administration of interferon-alpha or somatostatin analogue, are discussed. Particular note in this case is a prompt response of bone metastases to the radiotherapy.
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PMID:Disseminated pancreatic polypeptidioma. 814 81

We have investigated the possibility of using induction of MxA mRNA in patients with neuroendocrine tumors undergoing interferon-alpha(IFN-alpha) treatment as a predictive test for antitumor effect. A total of 122 patients with various types of neuroendocrine tumors were included in the study. Blood samples were drawn 12 hours after administration of either recombinant or natural IFN-alpha for analysis of induction of MxA mRNA in peripheral blood leukocyte (PBLs). Total RNA was isolated and slot-blot hybridization was performed using a MxA cDNA fragment as a probe. All patients displayed induction of MxA mRNA. Out of 13 untreated patients, 4 had MxA mRNA as well as 2 out of 11 patients treated with somatostatin analogue. All IFN-alpha treated patients showed induction of MxA mRNA and there was no difference between patients demonstrating partial remission, stable disease or progressive disease. Moreover, there was no difference between recombinant or natural leukocyte IFN-alpha in the ability to induce MxA mRNA. Six patients developed neutralizing IFN-alpha antibodies with 1 patient presenting a tire of 3200 NU/ml. Development of neutralizing antibodies did not abrogate the induction of MxA mRNA, but in 3 patients with high antibody titres the antitumor effect was lost. We therefore conclude that IFN-alpha is able to induce MxA mRNA in PBLs from patients with neuroendocrine tumors but we could not find any correlation with the therapeutic outcome. Furthermore, development of neutralizing IFN-alpha antibodies, although abrogating the antitumor effect, might not block the antiviral activity.
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PMID:Induction of MxA mRNA in patients with neuroendocrine tumors after interferon treatment. Lack of correlation with antitumor response. 857 23

This paper reviews data on the effect of pharmacological anti-tumour agents on tumour growth in patients with malignant gastro-enteropancreatic (GEP) tumours. Agents include long-acting somatostatin analogues, interferon-alpha, a combination of both, chemotherapy, and chemo-embolisation. Characteristics of tumours are considered which should be taken into account in the management of patients with metastatic endocrine GEP tumours, including growth rate. Tumour type should be matched to the anti-proliferative strategy.
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PMID:Control of growth in neuroendocrine gastro-enteropancreatic tumours. 881 74

Successful treatment of neuroendocrine tumor disease of the gastroenteropancreatic system requires a multimodal approach. Radical tumor surgery is required before other therapies are initiated. So far, only surgery has proven to be curative. If surgical intervention is not possible or a tumor-free state cannot be achieved, biotherapy with the somatostatin analogues octreotide or lanreotide should then be preferably carried out in patients with functional tumors. Interferon-alpha can alternatively be given. In patients with gastrinoma, therapy with proton pump inhibitors (e.g., omeprazol) is the initial treatment of choice. In patients with nonfunctional tumors, indication for treatment is only given in cases of documented tumor progress. In case of progressive tumor disease or functionality under the above-mentioned therapies, treatment with somatostatin analogues can be intensified by dose escalation or alternatively by a combination therapy with interferon-alpha and a somatostatin analogue. On the basis of the less favorable response of neuroendocrine foregut tumors to biotherapy, chemotherapy should be initiated after failure of biotherapy in documented tumor progression. A combination of streptozotocin and 5-fluorouracil, possibly combined with D,L-folinic acid, is the treatment of choice, considering the response and side effect rates. In case of predominantly anaplastic neuroendocrine tumors in advanced stages, good tumor response rates with a chemotherapeutic scheme consisting of cisplatin and etoposide can be achieved. Since the chemotherapy scheme is less effective in patients with midgut or hindgut tumors, chemoembolization of liver metastases should follow biotherapy. The response to chemoembolization may be increased by simultaneous systemic chemotherapy. Attention should always be paid to an adequate analgesic drug administration.
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PMID:Drug therapy in metastatic neuroendocrine tumors of the gastroenteropancreatic system. 889 42

The extent of apoptosis identified by in situ DNA nick end labelling (TUNEL) on tissue samples obtained from patients with neuroendocrine tumors was correlated with the clinical outcome in patients treated with high-dose somatostatin analog (lanreotide 12 mg/day), n = 8, or other biotherapy including interferon-alpha (IFN-alpha), n = 4, low-dose somatostatin analog (octreotide or lanreotide), n = 3, or a combination of both, n = 1. Biopsies were obtained before the start of treatment and/or after 6 months and 12 months. After 6 months of treatment, 5 patients receiving high-dose somatostatin analog showed a biochemical response (decrease in different neuroendocrine tumor markers) and 4 of these showed an increase in apoptotic index (AI: percentage of apoptotic cells) by 1.94 +/- 1.71%. At 12 months, AI was also increased in patients with a biochemical response (4.22 +/- 3.93%). However, none showed a decrease in tumor size on computerized tomography (CT) and none of the patients treated with low-dose somatostatin analog or IFN-alpha showed any significant increase in AI during treatment. In an experimental model, nude mice were xenografted with the neuroendocrine cell line (BON-1). From the 2nd day of tumor implantation, they received treatment with either placebo, high-dose octreotide, IFN-alpha, or a combination of both, for 28 days. In mice receiving treatment with high-dose octreotide (300 microg/kg, t.i.d) there was a threefold increase in apoptotic cells as compared to the placebo group (p = 0.0084), while the combination group had few cells with ultra-structural changes indicating apoptosis and the IFN-alpha treated group showed no significant changes. However, tumor growth inhibition was more pronounced in the combination group (p = 0.0011). This probably denotes that tumor growth inhibition could be achieved more efficiently by blocking the cell cycle than by inducing apoptosis. We concluded that treatment with high-dose somatostatin analogs may induce apoptosis in neuroendocrine tumors, while this is not found during treatment with low-dose somatostatin analogs or IFN-alpha. We also found that an increase in AI during high-dose somatostatin analog treatment was correlated with the biochemical response, but not with the tumor size as detected by CT in patients or with the tumor mass in the experimental model.
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PMID:Induction of apoptosis in neuroendocrine tumors of the digestive system during treatment with somatostatin analogs. 940 51

This study was designed to test the hypothesis that the immune changes seen during in vivo whole body hyperthermia are mediated by elevations in the plasma concentrations of either catecholamines, growth hormone or beta-endorphins. Eight healthy volunteers were immersed in a hot water bath (WI; water temperature 39.5 degrees C) for 2 h during which their rectal temperature rose to 39.5 degrees C. In a single blind, randomized, cross-over study the stress hormone effects were blocked one at a time by administration of propranolol, somatostatin or naloxone; the results were compared to those obtained during saline infusion (control). Blood samples were collected before, at the end of 2 h of WI (body temperature 39.5 degrees C), and 2 h later. Hormone blockade did not abolish the hyperthermia-induced recruitment of natural killer (NK) cells to the blood, and no influence was observed on the percentages or concentrations of any other subpopulations of blood mononuclear cells, except that the number of cluster designation (CD)3+ cells slightly increased after hyperthermia only in the propranolol experiment. Furthermore, the NK cell activity, both unstimulated and interferon-alpha or interleukin-2 stimulated, did not differ from the control situation. It is of interest, however, that somatostatin partly abolished the hyperthermia induced increase in the neutrophil number. Based on these data and previous results showing that growth hormone infusion increases the concentration of neutrophils in the blood, it is suggested that growth hormone is at least partly responsible for hyperthermia induced neutrocytosis.
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PMID:Somatostatin attenuates the hyperthermia induced increase in neutrophil concentration. 945 35

We have studied the expression of apoptosis regulating genes bcl-2 and bax in neuroendocrine gut tumors. The expression pattern of these genes was compared with the clinical response (changes in the tumor markers and changes of the tumor size determined by radiology) after treatment with interferon-alpha (IFN-alpha, n = 13), somatostatin analog (octreotide, n = 3; lanreotide, n = 2) or a combination of both (n = 5). Immunohistochemistry and in situ RT-PCR were performed and expressions were scored from 0 (no staining) to 6 (strong and wide-spread staining). With regard to clinical outcome, the scores (mean +/- SEM) of immunohistochemical staining of bcl-2 and bax were 1.77 +/- 0.25 and 4 +/- 0.22 for patients with stable disease and, 0.54 +/- 0.28 and 4.68 +/- 0.21 for patients with progressive disease. The scores of bcl-2 and bax staining for IFN-alpha-treated patients were 1.96 +/- 0.35 and 4.12 +/- 0.31 and for untreated patients were 0.5 +/- 0.25 and 4.5 +/- 0.21, respectively. Expression of bcl-2 was observed in all IFN-alpha-treated patients who responded to the drug but not in nonresponsive patients (p = 0.0027). In contrast, bax, a promotor of apoptosis was expressed in all patients with higher degree of expression seen in patients with progressive disease (p = 0.0364). We have also detected bcl-2 expression by western blot analysis in neuroendocrine tumor tissue grown in nude mice, which were treated with IFN-alpha for 28 days. Our results indicate that, IFN-alpha can induce bcl-2. Thus, we, propose that bcl-2 may be used as a prognostic marker for IFN-alpha sensitivity of neuroendocrine tumors.
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PMID:Interferon-alpha induces bcl-2 proto-oncogene in patients with neuroendocrine gut tumor responding to its antitumor action. 949 85


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