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)

Fifty episodes of bleeding from esophageal or gastric varices in 33 patients with cirrhosis were randomized to treatment with either intravenous terlipressin (2 mg initially and 1 mg every 4 hr for 24 hr together with bolus injection and continuous infusion of placebo) or with somatostatin (250 micrograms as a bolus and continuous infusion of 250 micrograms/hr somatostatin for 24 hr and placebo injections). Standard therapy with transfusions, fluid and electrolyte correction and lactulose was administered in both groups. In the terlipressin group, 22 of 25 bleeding episodes (88%) were initially stopped by the vasoactive drugs, and in the somatostatin group 19 of 25 bleeding episodes (76%) were initially stopped by the vasoactive drugs. Two of the three bleeding episodes not arrested by terlipressin and five of the six bleeding episodes not arrested by somatostatin were controlled by balloon tamponade. In one patient in each group variceal bleeding initially could not be stopped, and the patients died. The failure rate of the vasoactive treatment alone, including rebleeding episodes within the study period, was 20% in the terlipressin group and 32% in the somatostatin group. The control rate, including balloon tamponade, was 96% in both groups. The hospital mortality rate was 16% (4 of 25) in the terlipressin group and 24% (6 of 25) in the somatostatin group. Blood transfusions, use of balloon tamponade and duration of bleeding did not differ significantly.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Terlipressin vs. somatostatin in bleeding esophageal varices: a controlled, double-blind study. 135 May 62

Superior cervical ganglia from 7 human cadavers (3-7 h post mortem) were immunostained for tyrosine hydroxylase (TH), dopamine-beta-hydroxylase (DBH) and 14 different neuropeptides. The results show that ganglionic cells contain TH, DBH, neuropeptide Y (NPY), somatostatin, vasoactive intestinal polypeptide (VIP) and calcitonin gene-related peptide (CGRP). These substances were present predominantly within large ganglionic cells. Inside the ganglion, the number and topographical distribution of various types of immunoreactive cells differed from one another. NPY and CGRP immunoreactivities were found in some TH-positive cells, but that co-localization never exceeded the 30% of the TH cells. Leu-enkephalin showed a weak immunoreactivity, which was restricted to fibers or varicosities. Neuropeptides like substance P, dynorphin A and B, cholecystokinin, galanin, corticotropin-releasing factor, thyrotropin-releasing hormone, angiotensin II and neurotensin showed no immunoreactivity in the human superior cervical ganglion.
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PMID:Neuropeptides in the human superior cervical ganglion. 135 73

A double-labelling immunofluorescence study of rat spinal dorsal horn was carried out with antisera to Met-enkephalin and somatostatin. Varicosities in laminae I and II were frequently immunoreactive with both antisera, and in addition some neuronal cell bodies in lamina II possessed both types of immunoreactivity. These findings suggest that enkephalin and somatostatin coexist in some axons within the rat superficial dorsal horn and that at least some of these axons are derived from local neurones.
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PMID:Co-localization of Met-enkephalin and somatostatin in the spinal cord of the rat. 136 Oct 46

1) Emergency treatment. The best treatment remains endoscopic sclerotherapy, which controls the bleeding in 90% of the cases. Pharmacologic management stops the variceal hemorrhage in 80% of the cases and is indicated before endoscopic treatment can be performed. Intravenous somatostatin administration may be prolonged for 5 days, even more, and may thus prevent early rebleeding, which is not achieved neither by vasopressin nor by glypressin, which administration is restricted to 24 hours. Esophageal tamponade is useful to arrest a massive variceal bleeding, if vasoactive drugs are not available or not efficient, before endoscopic management. If the bleeding persists after 2 sclerotherapy sessions, an alternative treatment is mandatory: the patient should be sent to the surgeon for a portosystemic shunt if the operative risk is acceptable (child A and B) or should become a candidate for a transjugular intrahepatic stent shunt, especially if transplantation is considered afterwards. 2) Prevention of recurrent hemorrhage. A) Early (within 5 days after the initial bleeding). Somatostatin probably prevents early rebleeding, as do sclerotherapy. B) Late. B blockade (+ nitrates) or long-term sclerotherapy have the same efficacy. Their association may improve their results. 3) Prevention of the first bleeding episode. Propranolol decrease the risk of variceal rupture from 20% to 9% during the first year after the diagnosis of esophageal varices and is the only treatment which may be proposed to cirrhotics who did not yet bled form their varices.
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PMID:[Prevention and treatment of digestive hemorrhage due to ruptured esophageal varices in patients with cirrhosis]. 136 Oct 90

Postsynaptic targets of the GABAergic septohippocampal and the serotonergic raphe-hippocampal pathways were studied using anterograde tracing with Phaseolus vulgaris leucoagglutinin combined with pre- and postembedding immunocytochemistry in the rat. Two types of afferents were labeled in the hippocampus and dentate gyrus from the medial septum-diagonal band of Broca complex, one with large diameter varicosities and another with smaller terminals. The former type was shown to be immunoreactive for gamma-aminobutyric acid (GABA), and to innervate predominantly GABA-immunoreactive interneurons. Subsequently, these target interneurons were demonstrated to include all subpopulations of GABAergic cells which could be visualized by antisera against parvalbumin, calbindin D28k, calretinin, cholecystokinin, somatostatin, neuropeptide Y and vasoactive intestinal polypeptide. These types of interneurons have different afferent and efferent connections, and thus participate in different inhibitory processes in the hippocampal formation. The other subcortical pathway, the serotonergic projection from the median raphe nucleus, was also shown to establish synapses predominantly with GABAergic interneurons both in the hippocampus and in the dentate gyrus. In contrast to the septohippocampal projection, this pathway did not innervate all types of GABAergic neurons. They selected a particular subpopulation, i.e. those which contain calbindin D28k, and ignored those which contained parvalbumin or the other neurochemical markers. This suggests a strong functional specialization among local inhibitory circuits, as well as among the subcortical afferents originating in the septum and raphe. These findings suggest that a mechanism by which numerically small afferent pathways may have a profound global effect on the electrical activity of the hippocampal formation is the selective innervation of local interneurons. These GABAergic inhibitory cells, in turn, control the activity of large populations of principal cells. The level of GABAergic inhibition determines the degree of population synchrony and influences N-methyl-D-aspartate receptor-mediated epileptiform burst-firing. Thus, the specific subcortical modulation of hippocampal inhibitory circuits may also have fundamental implications for epileptogenesis.
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PMID:GABAergic septal and serotonergic median raphe afferents preferentially innervate inhibitory interneurons in the hippocampus and dentate gyrus. 136 33

Although the mechanism initiating and maintaining variceal hemorrhage is not completely understood, there has been general agreement in recent years on the concept that variceal rupture occurs when the tension on the wall of the varices reaches a critical value (the rupture point) that leads to the leakage of the elastic components of the wall. If this hypothesis is true, the aim of pharmacological treatment should be to reduce variceal wall tension or to prevent any abrupt increase in this parameter. Some vasoconstrictor drugs are currently used in order to achieve these goals and in the attempt to stop the acute bleeding episode. All these agents decrease either portal pressure and azygos blood flow. Vasopressin although effective, has significant cardiac and gastrointestinal adverse effects that discourage its use. Combination with nitroglycerin reduces its adverse effects while maintaining or even enhancing the reduction in portal pressure. Glypressin, which acts as a slow-release preparation of vasopressin, has a longer duration of action and can be administered as single intravenous injections instead of continuous infusion. However, the similarity of effects of these drugs on systemic circulation leads to an overlapping spectrum of untoward effects. Somatostatin and the synthetic octapeptide octreotide display similar pharmacological effects on splanchnic hemodynamics but have a better tolerability profile. Thanks to its longer duration of action and ease of administration, octreotide could become the drug of choice for the early, pre-hospital management of bleeding varices. A different approach to the pharmacological treatment of variceal bleeding may be the use of compounds, like metoclopramide and domperidone, that increase the lower esophageal sphincter pressure (LESP), thereby reducing the inflow of blood flow into the submucous venous plexus of the esophagus and hence into the esophageal varices. However, more studies are needed before these compounds be considered a real alternative to the above established drugs.
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PMID:Clinical pharmacology of active variceal bleeding. 136 76

The goals of therapy in acute variceal bleeding are to arrest haemorrhage and to prevent deterioration of liver function and complications related to bleeding. The measures used to stop acute bleeding should, ideally, also prevent the very early rebleeding that is frequently seen with bleeding varices. Variceal bleeding should be managed by a gastrointestinal bleeding team with intensive nursing care. Diagnostic endoscopy is mandatory once initial resuscitation has been achieved, and allows immediate injection sclerotherapy of varices. Drug therapy can be used as the first treatment in patients admitted with variceal bleeding since it can be given immediately. Of the available drugs, somatostatin has the least side effects and is as effective as vasopressin, terlipressin and the combination of vasopressin and an organic nitrate vasodilator. The role of drugs needs to be studied in combination with sclerotherapy. Sclerotherapy remains the mainstay of management as it achieves the twin goals of stopping active bleeding and preventing early rebleeding. Injection of tissue adhesive and endoscopic ligation or 'banding' are new endoscopic techniques that have shown promise in preliminary trials and are currently being assessed more widely. Balloon tamponade is a temporary measure used to prevent exsanguination. Surgery should be reserved for those patients in whom sclerotherapy is unsuccessful or cannot be carried out. Oesophageal staple transection is the most used operation. The new interventional radiological technique of transjugular intrahepatic portosystemic shunting will probably replace surgery in the future, but its role in acute variceal bleeding has yet to be fully defined.
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PMID:Acute management of bleeding oesophageal varices. 138 67

Following the demonstration that somatostatin lowered portal pressure in cirrhotic patients with portal hypertension, 2 uncontrolled reports suggested that the hormone might be useful in the control of acute variceal haemorrhage. Subsequently, a number of randomised controlled trials have indicated that somatostatin may have an efficacy as good as or better than either vasopressin or combined vasopressin and nitroglycerin therapy and is associated with fewer side effects. Somatostatin has an efficacy comparable to balloon tamponade, histamine-2-receptor antagonists and injection sclerotherapy. One double-blind randomised controlled trial demonstrated a significant benefit of somatostatin over placebo in the control of variceal bleeding whereas a second did not show any significant difference between treatments. In all the controlled trials, the average control rate achieved with somatostatin administration was 69% and it was not associated with any major side effects. Somatostatin administration has also been shown in uncontrolled series to be very effective in controlling postinjection sclerotherapy bleeding from the varices per se, and from oesophageal ulcers and oesophagitis. Few data are available on the long acting analogue of somatostatin, octreotide, but preliminary data suggest that it may be as effective and safe as the native hormone in controlling the acute variceal bleeding and postinjection sclerotherapy haemorrhage. It is concluded that there may be a case for instituting somatostatin therapy as soon as the patient enters hospital to facilitate sclerotherapy, and for continuing treatment for 5 days after sclerotherapy when the risk of recurrent bleeding is highest.
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PMID:Somatostatin in acute bleeding oesophageal varices. Clinical evidence. 138 69

Specific antiserum to somatostatin was used for the immunocytochemical detection of this neuropeptide in human dental pulp. Immunoreactive axon varicosities were observed in the radicular as well as coronal pulp. Fibers displaying somatostatin-like immunoreactivity were detectable within radicular nerve trunks and were found to be associated mainly with blood vessels. Nevertheless, positive fibers with no apparent relation to blood vessels were also observed. No pulp cell was found to be immunoreactive. Previous physiological studies demonstrated that somatostatin may function as a regulatory peptide in feline dental pulp via a pre-synaptic inhibition of substance P release from sensory nerve terminals. It is tempting to speculate that such a mechanism may also be effective in human teeth and may be of value in the regulation of pulpal blood flow and in situations when sensory nerve fibers are activated, e.g., during pulpal inflammation.
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PMID:Immunocytochemical evidence for the presence of somatostatin-like immunoreactive nerves in human dental pulp. 167 97

The anterior major pelvic ganglion (AMPG) of the male guinea-pig has been found to consist of three principal components. The presence of a cholinergic component was determined by the demonstration of cytoplasmic and nerve fibre acetylcholinesterase activity. A noradrenergic component was demonstrated by immunoreactivity (IR) of the catecholamine-synthesising enzymes tyrosine hydroxylase (TH) and dopamine-beta-hydroxylase (DBH) in neuronal perikarya. The AMPG also had a peptidergic component which may or may not sub-classify the cholinergic and noradrenergic components. Neuropeptide Y (NPY)-, vasoactive intestinal peptide (VIP)-, and atrial natriuretic factor (ANF)-immunoreactivities were seen in neuronal perikarya, nerve fibres and nerve terminals/varicosities, while somatostatin (SOM)-IR was restricted to neuronal perikarya. Substance P (SP)-IR was present in a dense network of varicose nerve fibres. However, on a rare occasion SP-IR was observed in neuronal perikarya. Enkephalin (ENK)-IR occurred in a sparsely distributed plexus of varicose nerve fibres. The analysis of adjacent serial sections demonstrated distinct patterns of neuropeptide coexistence in AMPG neurons. NPY-IR was colocalised to a subpopulation of TH-IR neuronal perikarya. NPY-IR was also colocalised with VIP-IR in non-TH-IR neuronal perikarya. VIP-IR occurred together with AChE in particular neuronal perikarya. The relationship between immunoreactive neuronal perikarya and immunoreactive nerve terminals was investigated. SP-IR nerve terminals were closely related to neuronal perikarya exhibiting VIP-, NPY-, or TH-IR. TH-IR neuronal perikarya were also abutted by ENK-IR nerve terminals. VIP- and NPY-immunoreactive neuronal perikarya were abutted by two nerve terminal types: one immunoreactive for VIP, the other for NPY. DBH-IR neuronal perikarya received AChE-positive varicosities while AChE-positive neurons were abutted by DBH-IR varicose nerve fibres. AChE-positive varicosities were also closely related to neuronal perikarya possessing VIP-IR and AChE activity.
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PMID:Specific patterns of immunoreactivity in neuronal elements of the anterior major pelvic ganglion of the male guinea-pig. 168 Aug 42


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