pituitrin and Neoplasms

Excessive secretion of vasopressin in the course of Syndrome of Inappropriate Antidiuretic Hormone Secretion is a common cause of hyponatremia in cancer patients. Clinical symptoms depend on the cause, rate of change of sodium level and their absolute values. Treatment options include fluid restrictions, intravenous administration of hypertonic sodium chloride solutions, loop diuretics and vaptans. The sodium level should not be adjusted too fast, because it may lead to irreversible brain damage. The article presents pathophysiology, diagnostics and recommendations of management of this oncological emergency.

Topics: Emergencies; Humans; Hyponatremia; Inappropriate ADH Syndrome; Infusions, Intravenous; Neoplasms; Saline Solution, Hypertonic; Vasopressins

The syndrome of inappropriate antidiuresis (SIAD; formerly the syndrome of inappropriate secretion of antidiuretic hormone) is the most frequent cause of hyponatremia. A strong association exists between mortality and hyponatremia, which reflects the severity of the underlying disease. In SIAD, hyponatremia is associated with normovolaemia but the assessment of extracellular volume can be difficult. Clinical features are mainly neurological and can lead to death but mechanisms of adaptation can limit cerebral oedema. The notion of mild asymptomatic hyponatremia was questioned by the observation of subclinical neurocognitive impairment, a greater risk of falls and fractures. Aetiologies are classified into six groups: neurologic disorders, infections mainly cerebral, meningeal and pulmonary, drugs in particular antidepressants, tumors, genetic causes, and idiopathic. Symptomatic acute hyponatremia is a therapeutic emergency that is not specific of SIAD. When hyponatremia is asymptomatic, fluid restriction with salt intake is generally sufficient but urea can be an alternative. In chronic SIAD, there is currently no recommendation. Fluid restriction is not always feasible; urea has proved its efficacy, its good tolerance and its long-term harmlessness. Vaptans have demonstrated their good tolerance and their efficacy on the correction of hyponatremia from SIAD in studies subgroups, for moderate hyponatremia and asymptomatic patients. In the only study having compared vaptans and urea, efficacy and tolerance were similar. Because of the cost difference between vaptans and urea and while waiting for follow-up studies, urea appears at present as the first-line treatment of hyponatremia in SIAD.

Topics: Diagnosis, Differential; Genetic Predisposition to Disease; Humans; Hyponatremia; Inappropriate ADH Syndrome; Infections; Neoplasms; Neurophysins; Protein Precursors; Vasopressins; Water-Electrolyte Balance

The non-peptide vasopressin antagonists (VPA), called vaptans, were developed in the 1990s to antagonize both the pressor and antidiuretic effects of vasopressin. There are three subtypes of VPA receptors: V1a, V1b and V2. V1a receptors are widely distributed in the body, mainly the blood vessels and myocardium. The V1b receptors are located mainly in the anterior pituitary gland and play a role in ACTH release. V2 receptors are located in the collecting tubular renal cells. Both V1a and V1b receptors act through the intracellular phosphoinositol signalling pathway, Ca(++) being the second messenger. V2 receptors work through AMPc generation, which promotes aquaporin 2 (AQP2) trafficking and allows water to enter the cell. The vaptans act competitively at the AVP receptor. The most important are mozavaptan, lixivaptan, satavaptan and tolvaptan, all of which are selective V2 antagonists and are administered through the oral route. In contrast, conivaptan is a dual V1 and V2 antagonist administered through the endovenous route. The main characteristics of vaptans are their effect on free water elimination without affecting electrolyte excretion. There are several studies on the effects of these drugs in hypervolemic hyponatremia (heart failure, hepatic cirrhosis) as well as in normovolemic hyponatremia (inappropriate secretion of ADH [SIADH]). Current studies show that the vaptans are effective and well tolerated, although knowledge of these drugs remains limited. There are no studies of the use of vaptans in severe hyponatremia. Osmotic demyelination syndrome due to excessively rapid correction of hyponatremia has not been described.

Topics: Adult; Antidiuretic Hormone Receptor Antagonists; Aquaporin 2; Benzamides; Benzazepines; Calcium Signaling; Clinical Trials as Topic; Cyclic AMP; Double-Blind Method; Drug Therapy, Combination; Heart Failure; Humans; Hyponatremia; Inappropriate ADH Syndrome; Kidney Tubules, Collecting; Liver Cirrhosis; Morpholines; Multicenter Studies as Topic; Neoplasms; Pituitary Gland, Anterior; Pyrroles; Randomized Controlled Trials as Topic; Receptors, Vasopressin; Second Messenger Systems; Spiro Compounds; Tolvaptan; Vasopressins

Desmopressin (DDAVP) is a well tolerated and convenient haemostatic agent that can be used in a number of clinical conditions with bleeding diathesis. It has several effects on the haemostatic system, causing endogenous release of coagulation factor VIII, von Willebrand factor and tissue-type plasminogen activator, among others. In this review we present a growing body of evidence showing that DDAVP treatment may impair spread of cancer cells and contribute to encapsulation of tumour tissue. Our data in preclinical animal models suggest a potential application of DDAVP in the perioperative management of aggressive solid tumours. Novel vasopressin analogues with improved antitumor effects are currently in development.

Topics: Animals; Deamino Arginine Vasopressin; Hemostatics; Humans; Neoplasm Invasiveness; Neoplasms; Vasopressins

Bleeding occurs in up to 10% of patients with advanced cancer. It can present in many different ways. This article provides a qualitative review of treatment options available to manage visible bleeding. Local modalities, such as hemostatic agents and dressings, radiotherapy, endoscopic ligation and coagulation, and transcutaneous arterial embolization, are reviewed in the context of advanced cancer, as are systemic treatments such as vitamin K, vasopressin/desmopressin, octreotide/somatostatin, antifibrinolytic agents (tranexamic acid and aminocaproic acid), and blood products. Considerations at the end of life are described.

Topics: Antifibrinolytic Agents; Bandages; Blood Transfusion; Endoscopy; Hemorrhage; Hemostatic Techniques; Humans; Neoplasms; Radiotherapy; Somatostatin; Terminal Care; Vasopressins; Vitamin K

Topics: Diagnosis, Differential; Humans; Hyponatremia; Inappropriate ADH Syndrome; Neoplasms; Osmotic Pressure; Plasma Volume; Prognosis; Vasopressins; Water Deprivation

Topics: Adrenocorticotropic Hormone; Adult; Arthritis, Rheumatoid; Humans; Hypothalamo-Hypophyseal System; Immunity; Inflammation; Interleukin-6; Middle Aged; Neoplasms; Pituitary-Adrenal System; Vasopressins

Topics: Biomarkers, Tumor; Carcinoma, Small Cell; Humans; Inappropriate ADH Syndrome; Lung Neoplasms; Neoplasms; Neurophysins; Oxytocin; RNA, Messenger; Vasopressins

Topics: Animals; Gastrin-Releasing Peptide; Gastrins; Growth Substances; Humans; Kinins; Neoplasms; Neuropeptides; Neurotensin; Peptides; Vasoactive Intestinal Peptide; Vasopressins

In an attempt to improve the therapeutic ratio of cytotoxic drugs, which have steep dose-response curves, microparticulate drug delivery systems (MDDS) have been designed for regional administration. Introduction of antineoplastic drug containing microspheres, of appropriate size, into the arterial system of an organ harboring primary or metastatic tumor, will cause tumor infarction by an embolic effect and provide a slow release source of drug trapped within the tumor microvasculature. This review describes recent innovations in synthesis of MDDS and their potential clinical application.

Topics: Antineoplastic Agents; Chemotherapy, Cancer, Regional Perfusion; Delayed-Action Preparations; Doxorubicin; Drug Combinations; Humans; Liver Neoplasms; Microcirculation; Microspheres; Mitomycins; Neoplasms; Urogenital Neoplasms; Vasopressins

Sixteen tumor markers are reviewed, and measured to the ideal: produced by the tumor cell alone absent in health and in benign disease present in all patients with a given malignancy level in the blood representative of tumor mass detectable in occult disease. The only marker that approaches the ideal is human chorionic gonadotropin (HCG) in gestational trophoblastic tumors. In this malignancy, the HCG level suggests the diagnosis and stage, confirms response to therapy, and predicts relapse. The three most widely used and intensely studied tumor markers are carcinoembryonic antigen (CEA), alphafetoprotein (AFP), and HCG. CEA cannot be used in screening for cancer, but in carcinoma of the colon its elevation preoperatively increases the likelihood of advanced disease and postoperative recurrence. Postoperatively, elevated titers are often but not invariably associated with recurrent disease. AFP and HCG are useful in the management of nonseminomatous germ cell testicular tumors. Like CEA, they cannot be used for screening. They are more likely to be increased with advancing stage, and after therapy rising levels almost always mean recurrent disease. Some markers are valuable in specific circumstances, such as calcitonin in screening for familial medullary carcinoma of the thyroid. In multiple myeloma, immunoglobulins are useful in determining the tumor mass and response to therapy. In neuroblastoma, catecholamine metabolites are useful primarily in making the diagnosis. In some malignancies, the absence of effective therapy lowers the value of the marker, as for AFP in hepatoma. The remaining markers are too unreliable or too little studied to be useful in the management of an individual patient with cancer. The purpose of this paper is to provide the clinician with an understanding of the limitations of the present tumor markers that will lead to wiser use of the tests, and to provide standards to which future tumor markers should be measured.

Topics: Acid Phosphatase; Adrenocorticotropic Hormone; Alkaline Phosphatase; alpha-Fetoproteins; Breast Neoplasms; Calcitonin; Carcinoembryonic Antigen; Catecholamines; Chorionic Gonadotropin; Colonic Neoplasms; Female; Ferritins; Humans; Hydroxyproline; Immunoglobulins; L-Lactate Dehydrogenase; Liver Neoplasms; Lung Neoplasms; Neoplasms; Neoplasms, Germ Cell and Embryonal; Parathyroid Hormone; Placental Lactogen; Polyamines; Pregnancy; Trophoblastic Neoplasms; Uterine Neoplasms; Vasopressins

Topics: Adrenocorticotropic Hormone; APUD Cells; Bombesin; Cell Differentiation; Chorionic Gonadotropin; Corticotropin-Releasing Hormone; Endorphins; Gene Expression Regulation; Gonadotropins; Growth Hormone; Growth Hormone-Releasing Hormone; Hormones, Ectopic; Humans; Insulin; Lymphokines; Mutation; Neoplasms; Parathyroid Hormone; Prolactin; Prostaglandins; Somatostatin; Thyrotropin; Vasoactive Intestinal Peptide; Vasopressins

Topics: Adrenocorticotropic Hormone; alpha-Fetoproteins; Antigens; Antigens, Neoplasm; Calcitonin; Carcinoembryonic Antigen; Chorionic Gonadotropin; Clinical Enzyme Tests; Fibrin Fibrinogen Degradation Products; Fibronectins; Glycoproteins; Growth Hormone; Humans; Neoplasms; Parathyroid Hormone; Peptides; Plasminogen Activators; Tissue Polypeptide Antigen; Vasopressins

Interventional radiology is defined as a radiologic subspecialty and the services provided are tabulated in this article; those services relevant to internists are described in greater detail. This article is intended as a survey, and the authors encourage the reader to consult the references provided for a more in-depth review.

Topics: Abscess; Angiography; Angioplasty, Balloon; Arterial Occlusive Diseases; Arteriovenous Malformations; Biopsy, Needle; Cholestasis; Drainage; Embolization, Therapeutic; Fibrinolytic Agents; Gastrointestinal Hemorrhage; Hemoptysis; Humans; Neoplasms; Peptic Ulcer; Radiography; Vasopressins

Topics: Adjuvants, Immunologic; Adrenocorticotropic Hormone; Animals; Appetite Depressants; Endorphins; Food Analysis; Hormones; Humans; Neoplasms; Peptides; Pituitary Hormone-Releasing Hormones; Vasopressins

Topics: Adrenocorticotropic Hormone; alpha-Fetoproteins; Antigens, Neoplasm; Calcitonin; Carcinoembryonic Antigen; Chorionic Gonadotropin; Glycoproteins; Hormones, Ectopic; Humans; Neoplasms; Placental Lactogen; Vasopressins

Topics: ACTH Syndrome, Ectopic; Adrenocorticotropic Hormone; Animals; Calcitonin; Cattle; Female; Hormones, Ectopic; Humans; Lung Neoplasms; Male; Neoplasms; Paraneoplastic Endocrine Syndromes; Rats; Thyroid Neoplasms; Vasopressins

Topics: Animals; Central Nervous System Diseases; Diagnosis, Differential; Humans; Hyponatremia; Hypothalamo-Hypophyseal System; Inappropriate ADH Syndrome; Neoplasms; Nephrons; Vasopressins; Water-Electrolyte Imbalance

Topics: Demeclocycline; Humans; Hypothyroidism; Inappropriate ADH Syndrome; Lithium; Neoplasms; Osmolar Concentration; Vasopressins

Topics: Angiography; Arteriovenous Malformations; Catheterization; Embolization, Therapeutic; Esophageal and Gastric Varices; Gastrointestinal Hemorrhage; Hemorrhage; Humans; Neoplasms; Regional Blood Flow; Vasopressins; Wounds and Injuries

Topics: Adrenocorticotropic Hormone; Calcitonin; Erythropoietin; Gonadotropins; Growth Hormone; Hormones, Ectopic; Humans; Hypercalcemia; Hypoglycemia; Neoplasms; Neurophysins; Oxytocin; Paraneoplastic Endocrine Syndromes; Parathyroid Hormone; Peptides; Placental Lactogen; Prolactin; Radioimmunoassay; Receptors, Cell Surface; Thyrotropin; Vasopressins

Topics: Adrenocorticotropic Hormone; Calcitonin; Child; Erythropoietin; Gastrins; Glucagon; Gonadotropins; Growth Hormone; Hormones, Ectopic; Humans; Insulin; Male; Melanocyte-Stimulating Hormones; Neoplasms; Parathyroid Hormone; Prostaglandins; Secretin; Serotonin; Thyrotropin; Vasopressins

Topics: Adrenocorticotropic Hormone; Arginine Vasopressin; beta-Lipotropin; Calcitonin; Gastrointestinal Hormones; Gonadotropins; Growth Hormone; Hormones, Ectopic; Humans; Hypercalcemia; Insulin; Insulin Secretion; Lung Neoplasms; Melanocyte-Stimulating Hormones; Neoplasm Proteins; Neoplasms; Neurophysins; Osteomalacia; Oxytocin; Paraneoplastic Endocrine Syndromes; Parathyroid Hormone; Phosphates; Placental Lactogen; Prolactin; Thyrotropin; Vasopressins

Topics: Adenocarcinoma; Adrenocorticotropic Hormone; Arginine; Biliary Tract Diseases; Bronchial Neoplasms; Carcinoma; Chorionic Gonadotropin; Colonic Neoplasms; Cushing Syndrome; Erythropoietin; Female; Follicle Stimulating Hormone; Growth Hormone; Gynecomastia; Hormones, Ectopic; Humans; Hypercalcemia; Lactation Disorders; Lung Neoplasms; Luteinizing Hormone; Models, Biological; Neoplasms; Paraganglioma; Paraneoplastic Endocrine Syndromes; Polycythemia; Pregnancy; Prolactin; Thyroid Neoplasms; Vasopressins

Topics: Acidosis; Acute Kidney Injury; Alkalosis; Amyloidosis; Hodgkin Disease; Humans; Hyperkalemia; Hypernatremia; Hypertension, Renal; Hypokalemia; Kidney; Kidney Concentrating Ability; Kidney Diseases; Multiple Myeloma; Neoplasms; Nephritis; Nephrotic Syndrome; Osmolar Concentration; Urine; Vasopressins; Water-Electrolyte Balance

Topics: Carcinoma, Bronchogenic; Cell Differentiation; Genes; Hormones, Ectopic; Humans; Liver Neoplasms; Lung Neoplasms; Microscopy, Electron; Mutation; Neoplasm Metastasis; Neoplasms; Paraneoplastic Endocrine Syndromes; Prognosis; Vasopressins

Topics: Adrenal Insufficiency; Diet, Sodium-Restricted; Diuretics; Humans; Hyponatremia; Neoplasms; Nephritis; Paraneoplastic Endocrine Syndromes; Sodium; Vasopressins

Topics: Animals; Body Fluids; Cell Membrane Permeability; Chlorides; Dogs; Extracellular Space; Heart Failure; Humans; Hyponatremia; Infant Nutrition Disorders; Kidney; Liver Cirrhosis; Neoplasms; Osmolar Concentration; Potassium; Respiratory Insufficiency; Sodium; Vasopressins; Water; Whipple Disease

Topics: Calcitonin; Erythropoietin; Female; Growth Hormone; Hormones, Ectopic; Humans; Neoplasms; Paraneoplastic Endocrine Syndromes; Placental Lactogen; Prolactin; Renin; Serotonin; Thyrotropin; Vasopressins

Topics: Adrenocorticotropic Hormone; Bronchial Neoplasms; Carcinoid Tumor; Cushing Syndrome; Endocrine System Diseases; Female; Gonadotropins; Hormones, Ectopic; Humans; Islets of Langerhans; Male; Neoplasms; Parathyroid Hormone; Thymus Neoplasms; Thyroid Neoplasms; Vasopressins

Topics: 5-Hydroxytryptophan; Acanthosis Nigricans; Carcinoid Tumor; Carotid Body Tumor; Catecholamines; Cushing Syndrome; Dermatomyositis; Endocrine System Diseases; Gynecomastia; Hormones, Ectopic; Humans; Hypercalcemia; Hyperthyroidism; Hypoglycemia; Hyponatremia; Neoplasms; Neuromuscular Diseases; Osteoarthropathy, Secondary Hypertrophic; Peripheral Nervous System Diseases; Polycythemia; Puberty, Precocious; Syndrome; Toxins, Biological; Vascular Diseases; Vasopressins; Zollinger-Ellison Syndrome

Topics: Aldosterone; Anesthesia, General; Blood Pressure; Body Fluids; Body Water; Capillary Permeability; Cell Membrane Permeability; Extracellular Space; Humans; Neoplasms; Osmotic Pressure; Plasma Volume; Postoperative Complications; Sodium; Vasopressins; Water-Electrolyte Balance

Topics: 5-Hydroxytryptophan; Adrenocorticotropic Hormone; Chorionic Gonadotropin; Gastrins; Hormones, Ectopic; Humans; Hypercalcemia; Hypoglycemia; Neoplasms; Parathyroid Hormone; Precancerous Conditions; Thyrotropin; Vasopressins

Topics: Adrenocorticotropic Hormone; Erythropoietin; Female; Gastrins; Gonadotropins; Hormones, Ectopic; Humans; Insulin; Male; Melanocyte-Stimulating Hormones; Neoplasms; Parathyroid Hormone; Thyrotropin; Vasopressins

Topics: Central Nervous System Diseases; Child; Edema; Endocrine System Diseases; Humans; Hyponatremia; Hypopituitarism; Lung Diseases; Male; Middle Aged; Neoplasms; Vasopressins

Topics: Adrenocorticotropic Hormone; Endocrine System Diseases; Erythropoietin; Gynecomastia; Hormones, Ectopic; Humans; Hypercalcemia; Hyperthyroidism; Hypoglycemia; Hyponatremia; Insulin; Luteinizing Hormone; Melanocyte-Stimulating Hormones; Neoplasms; Parathyroid Hormone; Polycythemia; Puberty, Precocious; Thyrotropin; Vasopressins

Topics: Adrenocorticotropic Hormone; Animals; Chemical Phenomena; Chemistry; Erythropoietin; Gastrins; Gonadotropins; Hormones, Ectopic; Humans; Immunochemistry; Melanocyte-Stimulating Hormones; Neoplasms; Parathyroid Hormone; Thyrotropin; Vasopressins

Topics: Adrenocorticotropic Hormone; Calcitonin; Chorionic Gonadotropin; Endocrine System Diseases; Erythropoietin; Gastrins; Hormones, Ectopic; Humans; Insulin; Lung Neoplasms; Neoplasms; Serotonin; Thyrotropin; Vasopressins

Topics: Acromegaly; Addison Disease; Adult; Central Nervous System Diseases; Diabetes Insipidus; Humans; Hyperthyroidism; Hypothyroidism; Kidney; Lung Diseases; Male; Neoplasms; Pituitary Diseases; Thyroid Diseases; Vasopressins

Topics: Central Nervous System Diseases; Humans; Hypopituitarism; Lung Diseases; Neoplasms; Vasopressins

Topics: Animals; Brain; Humans; Neoplasms; Neurosecretion; Stress, Physiological; Vasopressins

Topics: Adrenocortical Hyperfunction; Adrenocorticotropic Hormone; Breast Diseases; Endocrine System Diseases; Gynecomastia; Humans; Lung Diseases; Lung Neoplasms; Male; Neoplasms; Syndrome; Vasopressins

Topics: Adenoma, Islet Cell; Adrenocortical Hyperfunction; Adrenocorticotropic Hormone; Alkalosis; Cushing Syndrome; Electrolytes; Endocrinology; Humans; Hypernatremia; Hypokalemia; Hyponatremia; Neoplasms; Pancreatic Neoplasms; Vasopressins; Water-Electrolyte Balance

Previous trials suggest that vasopressin may improve outcomes in patients with vasodilatory shock. The aim of this study was to evaluate whether vasopressin could be superior to norepinephrine to improve outcomes in cancer patients with septic shock.. Single-center, randomized, double-blind clinical trial, and meta-analysis of randomized trials.. ICU of a tertiary care hospital.. Two-hundred fifty patients 18 years old or older with cancer and septic shock.. Patients were assigned to either vasopressin or norepinephrine as first-line vasopressor therapy. An updated meta-analysis was also conducted including randomized trials published until October 2018.. The primary outcome was all-cause mortality at 28 days after randomization. Prespecified secondary outcomes included 90-days all-cause mortality rate; number of days alive and free of advanced organ support at day 28; and Sequential Organ Failure Assessment score 24 hours and 96 hours after randomization. We also measure the prevalence of adverse effects in 28 days. A total of 250 patients were randomized. The primary outcome was observed in 71 patients (56.8%) in the vasopressin group and 66 patients (52.8%) in the norepinephrine group (p = 0.52). There were no significant differences in 90-day mortality (90 patients [72.0%] and 94 patients [75.2%], respectively; p = 0.56), number of days alive and free of advanced organ support, adverse events, or Sequential Organ Failure Assessment score.. In cancer patients with septic shock, vasopressin as first-line vasopressor therapy was not superior to norepinephrine in reducing 28-day mortality rate.

Topics: Double-Blind Method; Female; Humans; Male; Middle Aged; Neoplasms; Norepinephrine; Shock, Septic; Vasoconstrictor Agents; Vasopressins

Topics: Adrenocorticotropic Hormone; Adult; Arthritis, Rheumatoid; Humans; Hypothalamo-Hypophyseal System; Immunity; Inflammation; Interleukin-6; Middle Aged; Neoplasms; Pituitary-Adrenal System; Vasopressins

Topics: Adaptor Protein Complex 2; Animals; beta-Arrestins; Cell Membrane; Focal Adhesion Protein-Tyrosine Kinases; GTP-Binding Proteins; HEK293 Cells; Humans; Mice; Multiprotein Complexes; Neoplasms; Phosphorylation; Protein Binding; Protein Domains; Receptor, Angiotensin, Type 1; Receptors, G-Protein-Coupled; Vasopressins

Topics: Humans; Neoplasms; Norepinephrine; Shock, Septic; Vasoconstrictor Agents; Vasopressins

Topics: Humans; Neoplasms; Norepinephrine; Shock, Septic; Vasopressins

Sleep impairment is one of the major side effects of glucocorticoid therapy. The mechanism responsible for this circadian disorder is unknown, but alterations in the suprachiasmatic nucleus (SCN), the biological clock of the human brain, are presumed to play a major role. In the present study, the amount of vasopressin mRNA (AVP mRNA) expression in the SCN was investigated in 10 glucocorticoid-exposed patients and 10 glucocorticoid free, age- and clock time of death-matched controls. The total amount of AVP mRNA, expressed as masked silver grains in the SCN, was two times lower in glucocorticoid-exposed patients (n = 10; 5115 +/- 1314 microm(2)) than that in controls (n = 10; 11,021 +/- 1408 microm(2)) (P = 0.006). There was also a 53% decrease in the total number of profiles in the SCN that expressed AVP mRNA in glucocorticoid-exposed patients (16,759 +/- 3110) compared with those in controls (31,490 +/- 3816) (P = 0.01). In conclusion, glucocorticoids have an inhibitory effect on AVP mRNA expression in the human SCN, which may be the biological basis of the circadian rhythm disturbances during glucocorticoid therapy.

Topics: Adult; Aged; Autopsy; Cardiovascular Diseases; Female; Gene Expression; Glucocorticoids; Humans; Male; Middle Aged; Neoplasms; RNA, Messenger; Suprachiasmatic Nucleus; Vasopressins

The aim of this study was to investigate the relationship among motility disorders, dyspeptic symptoms, and plasma levels of gastrointestinal hormones in cancer patients who were well controlled for post-chemotherapy emesis.. Twenty-five cancer patients treated with standard dosages of antiemetics and chemotherapies completed the study. Gastrointestinal symptoms were investigated by detailed questionnaire and visual analog score. Motility was investigated by cutaneous electrogastrography, and by blood levels of gastrin, serotonin, vasopressin, and substance P, before and 7 days after chemotherapy.. Before chemotherapy, no patient complained of dyspeptic symptoms, and no differences in electrogastrography (EGG) or in circulating peptide levels were found between patients who developed dyspepsia and those who did not. After chemotherapy, 13 patients suffered from dysmotility-like symptoms (total symptom score, 11.5 [2.5-37.9]; median value and 5th-95th percentiles), with susceptibility to nausea, early satiety, and postprandial fullness being the major complaints. As regards EGG parameters, a significant reduction (P = 0.04; Mann-Whitney test) in the normal slow-wave percentage and significantly increased tachygastria percentage were found in dyspeptic patients compared with symptom-free patients. The tachygastria percentage was significantly associated with susceptibility to nausea score, in a non-linear fashion (R2 = 0.37). Dyspeptic patients showed lower levels of substance P and gastrin than patients who were not dyspeptic, but this difference had no clinical significance for dyspepsia.. Chemotherapy may induce upper gastrointestinal symptoms suggestive of motility disorders. These dyspeptic symptoms were associated with EGG alterations, but not with variations in circulating peptides. Other hormones or pathophysiological factors, not considered in the present work, could be actively involved in these dyspeptic symptoms.

Topics: Aged; Antineoplastic Agents; Dyspepsia; Electrophysiology; Female; Gastrins; Gastrointestinal Hormones; Gastrointestinal Motility; Humans; Male; Neoplasms; Serotonin; Stomach; Substance P; Vasopressins

The presence of 3 different neuropeptide mRNAs with a strict cell-specific expression in vivo was investigated in 13 tumor cell lines from neuroendocrine and in 23 tumor cell lines from non-neuroendocrine origin. Northern blots showed no expression of mRNA for vasopressin (VP) in the 36 tested cell lines. Very low oxytocin (OT) mRNA hybridization signals were detected in the rat pituitary tumor cell line GH4C2 and the rat pancreas tumor cell line RIN5. Both the rat pituitary tumor cell line AtT-20 and the human myeloid leukemia cell line K562, contained proopiomelanocortin (POMC) mRNA. The low incidence of VP, OT and POMC gene expression in the tested tumor cell lines was not influenced by treatments inducing differentiation. In contrast, the cholecystokinin (CCK) gene which is widely present in nervous and endocrine systems was abundantly expressed in the human primitive neuroepithelioma cell line SK-N-MC and its clonal derivative SK-N-MC-IX-C. The results indicate that the expression of neuropeptide genes is very rare in tumor cell lines. The lack of expression in undifferentiated cells agrees with the appearance of expression after day 13 of the embryogenesis when maturation of neurons begins.

Topics: Animals; Blotting, Northern; Cell Differentiation; Cholecystokinin; Gene Expression Regulation, Neoplastic; Humans; Mice; Neoplasms; Neoplasms, Experimental; Neoplasms, Nerve Tissue; Neuropeptides; Oxytocin; Paraneoplastic Endocrine Syndromes; Pro-Opiomelanocortin; Rats; RNA, Messenger; RNA, Neoplasm; Swine; Tumor Cells, Cultured; Vasopressins

Several authors have demonstrated that vasopressin (VP) plays a role in the metabolism of various cell lines, cancerous or not, and in particular acts upon the growth and the multiplication of cell cultures. Less known are the data concerning the existence of an adrenal-postpituitary imbalance in favour of VP in cancerous patients. Seeing that adreno-cortical hormones (ACH) are able to exert an inhibiting action on cell multiplication in vitor, a similar effect being very moderate or even absent in vivo, one can see the advantage of taking such effects into account. They allowed us to explain the discrepancy between the in vivo and in vitro effects of ACH, since VP is able to counteract the expected effects of ACH. A model, first empirical, then mathematical, of the so-called adrenal-postpituitary system, was proposed for this purpose. It enables us to propose some hypotheses in the fight to escape the action of ACH in cancer. Paradoxically, it seems that a bipolar therapy, using ACH and VP, would be useful in reaching this goal.

Topics: Animals; Humans; Models, Biological; Neoplasms; Pituitary-Adrenal System; Vasopressins

Topics: Aged; Antineoplastic Agents; Atrial Natriuretic Factor; Humans; Inappropriate ADH Syndrome; Lung Diseases; Male; Neoplasms; Vasopressins

Neuro-adrenolysis of the pituitary gland by injection of pure alcohol was done to control intractable pain associated with wide-spread cancer, and pituitary functions were measured before and after the injection. Of a series of 46 patients undergoing a total of 57 neuro-adrenolysis of the pituitary gland, 22 (38.6%) of these procedures obtained complete pain relief 22 (38.6%) showed improvement, and the remaining 13 (22.8%) no effect. Hormonal changes of pituitary gland were not same among the cases and there was no correlation between hormonal changes and the occurrence of pain relief. Experimental study was done to investigate the effect of hypophysectomy and intracerebroventricular injection of AVP on pain threshold in rats. The study revealed that hypophysectomy and ventricular injection of AVP dose dependently raised pain threshold and these effects were inhibited by naloxone. These facts suggest that the analgesic effects of hypophysectomy and AVP injection into cerebral ventricle are mediated by beta-endorphin.

Topics: Adolescent; Adrenocorticotropic Hormone; Adult; Aged; Animals; Child; Ethanol; Female; Humans; Hydrocortisone; Male; Middle Aged; Naloxone; Neoplasms; Nerve Block; Pain, Intractable; Pituitary Gland; Rats; Rats, Inbred Strains; Vasopressins

The property of aerobic glycolysis commonly possessed by malignant cells points to a weakness in oxidative metabolism which has been equated in some tumours with partial uncoupling of oxidative phosphorylation. The suggestions are made, first, that this endogenous defect may account for spontaneous cell death in situ, and, second, that its accentuation would inflict extensive tumour injury upon sensitive neoplasms. Certain drugs not in current use for the treatment of malignant disease are known to be able to interfere selectively with energy metabolism in sensitive tumours to such an extent that widespread necrotization ensues. The drugs activate an endogenous destructive mechanism that appears to require oxygen. Liminal therapy, the maintenance of continuous destructive pressure on sensitive growths in such a manner that maximal anti-tumour activity in terms of interference with energy production is not achieved at any one time, and under conditions in which the oxygen supply is only partly depleted, is put forward as a possible means of achieving complete and selective tumour destruction in vivo.

Topics: Animals; Antineoplastic Agents; Cell Survival; Dihydralazine; Drug Resistance; Energy Metabolism; Humans; Hydralazine; Isoproterenol; Mice; Naphazoline; Neoplasms; Oxygen; Oxygen Consumption; Phenylephrine; Sarcoma, Experimental; Time Factors; Vasopressins

Topics: Adult; Aged; Catheterization; Embolization, Therapeutic; Female; Gastrointestinal Hemorrhage; Humans; Infusions, Intra-Arterial; Male; Middle Aged; Neoplasms; Postoperative Complications; Vasopressins

Topics: Adrenocorticotropic Hormone; Calcitonin; Female; Hormones, Ectopic; Humans; Male; Neoplasms; Vasopressins

Topics: Adrenocorticotropic Hormone; Chorionic Gonadotropin; Hormones; Hormones, Ectopic; Humans; Neoplasms; Paraneoplastic Endocrine Syndromes; Vasopressins

An attempt is made to justify the model of the regulation of agonistic-antagonistic hormonal couples (in the field of the adrenal-postpituitary interrelationships). A method of synthesis for these equations is proposed. Cancerous pathology of this regulation could be due to a disturbance in the secretion or in the catabolism of vasopressin.

Topics: Adrenal Cortex Hormones; Adrenocorticotropic Hormone; Animals; Diabetes Mellitus; Humans; Hypothalamo-Hypophyseal System; Models, Biological; Neoplasms; Pituitary Hormones; Pituitary-Adrenal System; Receptors, Cell Surface; Vasopressins

To elucidate the mechanism of cyclophosphamide (CTX)-induced antidiuresis, plasma and urine volume as well as serum electrolytes, creatinine, osmolality, and appropriate hormones were monitored serially during 19 courses of chemotherapy. In spite of plasma hypotonicity and urinary hypertonicity, the plasma vasopressin concentrations were unaltered. Intravenous isotonic hydration did not prevent water retention, but did not lead to plasma hypotonicity, and compensated for modest urinary sodium losses. Furosemide diuresis did not prevent the development of hyponatremia in patients receiving hypotonic hydration. The results indicate that the origin of this self-limited syndrome is a direct effect of CTX on the renal tubule, permitting increased water reabsorption and sodium loss. The likelihood that water and salt imbalance will develop after CTX administration can be reduced by vigorous isotonic hydration, and pharmacological diuresis.

Topics: Adolescent; Adult; Child; Cyclophosphamide; Diuresis; Drug Therapy, Combination; Female; Furosemide; Humans; Male; Middle Aged; Neoplasms; Sodium; Vasopressins

Plasma and urinary arginine vasopressin (AVP) in normal subjects and in patients with various water metabolism disorders was measured using a sensitive, specific radioimmunoassay. The AVP plasma levels in normal subjects were 3.1 +/- 1.2 pg/ml. The parallel changes in plasma osmolality, plasma AVP concentration, and urinary osmolality were observed after water load. In patients with various kinds of hyponatremia and impaired water excretion, plasma AVP concentrations were within or over normal levels, suggesting that persistent secretion of AVP may play an important role in the pathogenesis of hyponatremia. Variable levels of plasma AVP were observed in patients with essential hypernatremia, which in turn suggested that osmoreceptors may be selectively damaged in some patients, and that ADH-secreting neurons are also involved in others. Our radioimmunoassay facility made it possible for us to measure plasma and urinary DDAVP in the treatment of diabetes insipidus.

Topics: Adrenal Insufficiency; Adult; Animals; Arginine Vasopressin; Ascites; Diabetes Insipidus; Dogs; Edema; Humans; Hypernatremia; Hyponatremia; Hypotension, Orthostatic; Infant; Neoplasms; Osmolar Concentration; Radioimmunoassay; Vasopressins; Water

Topics: Drug Therapy, Combination; Humans; Neoplasm Metastasis; Neoplasms; Syndrome; Vasopressins; Vinblastine

Ectopic production and secretion of hormones by a wide variety of tumors were initially recognized by signs and symptoms of excess circulating biologically active hormone. With the development of more sophisticated and sensitive techniques, it has become apparent that not all tumors secrete biologically active hormones. Some altered forms of polypeptide hormones may be in very high concentrations immunologically but be inactive biologically. On the other hand, polypeptide hormones may circulate at concentrations too low to induce clinical signs and symptoms. Consequently, new ectopic humoral syndromes have been recognized and the incidence of previously described syndromes has become considerably greater than previously recognized. Every hormone known to be normally secreted by endocrine organs or the placenta has been documented to be secreted ectopically by a wide variety of tumors. Moreover, several of those hormones may be used as biochemical markers of malignancy for both screening and monitoring of patients with documented or suspected tumors.

Topics: Adrenocorticotropic Hormone; Chorionic Gonadotropin; Growth Hormone; Hormones, Ectopic; Humans; Hypercalcemia; Luteinizing Hormone; Neoplasms; Neurophysins; Paraneoplastic Endocrine Syndromes; Parathyroid Hormone; Placental Lactogen; Vasopressins

Topics: Adrenocorticotropic Hormone; Genetic Code; Hormones, Ectopic; Humans; Neoplasms; Paraneoplastic Endocrine Syndromes; Peptides; Vasopressins

Topics: Adrenocorticotropic Hormone; Animals; Gonadotropins, Pituitary; Growth Hormone; Humans; Neoplasms; Pituitary Hormone-Releasing Hormones; Pituitary Hormones; Vasopressins

Topics: Humans; Kidney; Neoplasms; Neurophysins; Radioimmunoassay; Vasopressins

The exact prevalence of the humoral syndromes associated with neoplasm is not known but it seems clear that they exist more commonly than is realized. Hormonal syndromes are very often seen in patients with carcinoma of the lung. Awareness of the large number of ectopic hormonal syndromes in patients with tumors can lead to early diagnosis, treatment, and herald recurrence. They may be responsible for new signs and symptoms which can be life-shortening. Hormonal causes of clinical deterioration must be considered before concluding that symptoms are due to metastases in patients with neoplastic disease. Tumors are chemically active and the important concept which has had great impact on the diagnosis, treatment, and basic understanding of mechanisms, which are important to endocrinologists and oncologists has been stated by Liddle: "Certain tumors of nonendocrine tissue can produce hormones that are similar to normal hormones except that their production is not appropriately controlled by normal physiologic mechanisms." Survival and quality of life can be reduced in patients with the metabolic complications of these humors. The list of humoral substances released by tumors is growing as technologic advances lead to their detection. Other chemical substances produced by neoplastic tissue may have biologic activity which impacts on the patient's clinical condition and which we cannot recognize, at this time, because the techniques to detect them have not been developed. If there are signs or symptoms of overproduction of a hormone, search for a tumor; if a patient has a tumor, search for biologically active substances.

Topics: Cushing Syndrome; Erythropoietin; Hormones; Hormones, Ectopic; Humans; Hypercalcemia; Hypoglycemia; Neoplasms; Paraneoplastic Endocrine Syndromes; Vasopressins

Topics: Adolescent; Adult; Amino Acids; Body Weight; Calcium; Cyclophosphamide; Cystitis; Diuresis; Female; Glomerular Filtration Rate; Humans; Hyponatremia; Kidney; Kidney Concentrating Ability; Male; Middle Aged; Natriuresis; Neoplasms; Osmolar Concentration; Phosphorus; Potassium; Proteinuria; Uric Acid; Vasopressins

Topics: Adrenocorticotropic Hormone; Cell Transformation, Neoplastic; Cushing Syndrome; Humans; Hypercalcemia; Hyponatremia; Neoplasms; Parathyroid Hormone; Precancerous Conditions; Vasopressins

Topics: Adult; Aged; Cyclophosphamide; Diuresis; Female; Glomerular Filtration Rate; Hodgkin Disease; Humans; Inulin; Kidney; Male; Mechlorethamine; Middle Aged; Neoplasms; Osmolar Concentration; Potassium; Sodium; Time Factors; Vasopressins

Topics: Adrenal Cortex Hormones; Adrenal Glands; Aldosterone; Blood Volume; Diabetes Insipidus; Humans; Neoplasms; Pituitary Gland, Posterior; Stress, Physiological; Vasopressins

Topics: Adrenal Gland Diseases; Endocrine System Diseases; Erythrocytes; Female; Gastrins; Gynecomastia; Hormones, Ectopic; Humans; Hypercalcemia; Hyperplasia; Hyperthyroidism; Hypoglycemia; Male; Malignant Carcinoid Syndrome; Metabolic Diseases; Neoplasms; Neurologic Manifestations; Polycythemia; Prognosis; Puberty, Precocious; Vasopressins

Topics: Adrenocorticotropic Hormone; Gonadotropins; Hormones, Ectopic; Humans; Neoplasms; Thyrotropin; Vasopressins

Topics: Arginine; Humans; Methods; Neoplasms; Pituitary Gland, Posterior; Radioimmunoassay; Vasopressins

Topics: Aged; Female; Hormones, Ectopic; Humans; Male; Middle Aged; Neoplasms; Vasopressins

Topics: Adolescent; Adult; Aged; Aldosterone; Blood Glucose; Fasting; Fever; Glomerular Filtration Rate; Glucose; Humans; Hyponatremia; Insulin; Middle Aged; Natriuresis; Neoplasms; Osmolar Concentration; Sodium; Tuberculosis; Vasopressins

Topics: Animals; Dogs; Electrolytes; Hormones, Ectopic; Humans; Hyponatremia; Lung Neoplasms; Lymphoma; Neoplasms; Pancreatic Neoplasms; Stomach Neoplasms; Vasopressins

Topics: Central Nervous System Diseases; Endocrine System Diseases; Humans; Hyponatremia; Kidney Tubules; Lung Diseases; Neoplasms; Osmolar Concentration; Vasopressins

Topics: Heart Failure; Humans; Liver Cirrhosis; Lung Diseases; Neoplasms; Nephrosis; Vasopressins; Water-Electrolyte Balance

Topics: Central Nervous System Diseases; Female; Hormones, Ectopic; Humans; Hyponatremia; Lung Diseases; Male; Neoplasms; Vasopressins

Topics: Adrenocorticotropic Hormone; Adult; Cushing Syndrome; Female; Gastrins; Glucagon; Humans; Male; Melanocyte-Stimulating Hormones; Middle Aged; Neoplasms; Norepinephrine; Parathyroid Hormone; Serotonin; Vasopressins

Topics: Animals; Biological Assay; Blood Pressure; Body Fluids; Diuresis; Electric Conductivity; Electrolytes; Neoplasms; Rats; Tissue Extracts; Vasopressins

Topics: Brain Neoplasms; Breast Neoplasms; Diuresis; Female; Humans; Inappropriate ADH Syndrome; Neoplasms; Vasopressins

Topics: Adrenal Cortex Hormones; Adrenocorticotropic Hormone; Adult; Aged; Brain Diseases; Endocrine System Diseases; Female; Humans; Male; Middle Aged; Neoplasms; Oxytocin; Vasopressins; Water-Electrolyte Balance

Topics: Humans; Hyponatremia; Natriuresis; Neoplasms; Urine; Vasopressins

Topics: Arginine Vasopressin; Bronchial Neoplasms; Carcinoma, Bronchogenic; Humans; Hyponatremia; Inappropriate ADH Syndrome; Lymphatic Metastasis; Natriuresis; Neoplasms; Physiology; Urine; Vasopressins

Topics: Child; Dehydration; Drug Therapy; Humans; Hypernatremia; Hypothalamus; Hypothyroidism; Metabolism; Neoplasms; Neurosurgery; Pinealoma; Pituitary-Adrenal Function Tests; Prednisone; Thirst; Triiodothyronine; Vasopressins; Water-Electrolyte Balance

Topics: Arginine Vasopressin; Bronchial Neoplasms; Carcinoma; Carcinoma, Bronchogenic; Drug Therapy; Fluids and Secretions; Humans; Hyponatremia; Mechlorethamine; Neoplasms; Urine; Vasopressins

Topics: 5-Hydroxytryptophan; Carcinoid Tumor; Carcinoma, Hepatocellular; Carotid Body Tumor; Catecholamines; Cushing Syndrome; Endocrine System Diseases; Female; Fibrosarcoma; Humans; Hyperthyroidism; Hypoglycemia; Hyponatremia; Liver Neoplasms; Lung Neoplasms; Male; Neoplasms; Polycythemia Vera; Puberty, Precocious; Vasopressins

Topics: Humans; In Vitro Techniques; Neoplasms; RNA, Neoplasm; Vasopressins

Topics: Adrenocorticotropic Hormone; Aldosterone; Arginine Vasopressin; Ascites; Blood; Bradykinin; Cell Division; Cell Nucleus; Cortisone; Cricetinae; Estrone; Follicle Stimulating Hormone; Histamine; Hydrocortisone; In Vitro Techniques; Luteinizing Hormone; Microscopy; Microscopy, Phase-Contrast; Neoplasms; Neoplasms, Experimental; Oxytocin; Peptides; Pharmacology; Progesterone; Research; Serotonin; Testosterone; Tissue Culture Techniques; Vasopressins

Topics: Blood Chemical Analysis; Bronchial Neoplasms; Carcinoma; Humans; Hyponatremia; Metabolism; Neoplasms; Urine; Vasopressins

Topics: Anuria; Arginine Vasopressin; Blood; Busulfan; Chromatography; Colorimetry; Fluids and Secretions; Glucose; Hypertonic Solutions; Mannitol; Metabolism; Neoplasms; Pharmacology; Rats; Research; Sodium Chloride; Sorbitol; Triethylenemelamine; Urine; Vasopressins

Topics: Animals; Ascites; Carcinoma, Ehrlich Tumor; Chlorothiazide; Heparin; Histamine; Hydrocortisone; Mice; Neoplasms; Neoplasms, Experimental; Pharmacology; Radiation; Radiation Effects; Research; Vasopressins

Topics: Carcinoid Tumor; Cushing Syndrome; Humans; Hyperthyroidism; Hypoglycemia; Neoplasms; Pheochromocytoma; Polycythemia; Puberty; Puberty, Precocious; Sexual Maturation; Vasopressins

Topics: Adrenocorticotropic Hormone; Cushing Syndrome; Diabetes Insipidus; Diabetes Insipidus, Neurogenic; Diabetic Nephropathies; Endocrine Glands; Endocrine System Diseases; Hormones; Humans; Hypercalcemia; Hypothyroidism; Liver Diseases; Lung Neoplasms; Neoplasms; Nephrosis; Polycythemia; Pseudopseudohypoparathyroidism; Vasopressins

Topics: Autonomic Nerve Block; Carcinoma; Chlorpromazine; Geriatrics; Histocytochemistry; Humans; Kidney Diseases; Lung Neoplasms; Neoplasm Metastasis; Neoplasms; Nitrogen Mustard Compounds; Vasopressins

Topics: Adrenal Cortex; Adrenal Cortex Hormones; Adrenocorticotropic Hormone; Diabetes Insipidus; Diabetes Insipidus, Neurogenic; Humans; Neoplasms; Pituitary Gland; Pituitary Neoplasms; Vasopressins