vasoactive-intestinal-peptide and Celiac-Disease

Vasoactive intestinal peptide (VIP), first isolated from the gut, was originally considered a candidate gastrointestinal hormone. Since about 1975, however, it has become increasingly clear that it is primarily a neurotransmitter or neuromodulator and that it exerts its functions mainly by local release from nerve endings. VIP plays a hormonal role only when it is released in large amounts from a tumor, with a consequent overflow into the circulation and grossly elevated plasma concentrations of the peptide. Moderately increased VIP plasma and tissue concentrations that cause mainly local effects are found in intestinal ischemia. Crohn's disease and some other chronic inflammatory diseases of the bowel. VIP is also measured in increased amounts in the normal fetus and neonate, where it may play an important physiological role. Such an increase of VIP levels in the circulation could enhance perfusion and metabolic activity of tissues during their rapid-growth period. On the other hand, disorders with a disturbed VIP function such as achalasia and Hirschsprung's disease and possibly also asthma and cystic fibrosis seem to be characterized mainly by a derangement of smooth muscle activity and/or exocrine secretion. Considering this list of disorders where VIP has either a proven or suspected role, it is easy to imagine the significance of this peptide in pediatric pathophysiology.

Topics: Asthma; Bronchodilator Agents; Celiac Disease; Child; Child, Preschool; Crohn Disease; Cystic Fibrosis; Digestive System; Esophageal Achalasia; Hirschsprung Disease; Humans; Hypoxia; Infant; Infant, Newborn; Placenta; Vasoactive Intestinal Peptide; Vipoma

Amelioration or cure of hypertension, hypercortisolism, diarrhea with steatorrhea, and massive proteinuria resulted from excision of a pheochromocytoma that contained immunoreactive ACTH, VIP, and somatostatin. Ectopic ACTH production by the tumor was clearly the cause of the hypercortisolism, and the possible involvement of VIP and somatostatin in the diarrhea and steatorrhea was considered. The response to tumor removal suggested that the mesangioproliferative glomerulonephritis shown on renal biopsy was also a paraneoplastic phenomenon.

Topics: Adrenal Gland Neoplasms; Adrenocortical Hyperfunction; Adrenocorticotropic Hormone; Celiac Disease; Diarrhea; Humans; Hydrocortisone; Hypertension; Male; Middle Aged; Pheochromocytoma; Proteinuria; Somatostatin; Vasoactive Intestinal Peptide

Topics: Adrenal Gland Neoplasms; Celiac Disease; Child, Preschool; Chronic Disease; Cystic Fibrosis; Diagnosis, Differential; Diarrhea; Ganglioneuroma; Gastrointestinal Hormones; Humans; Male; Vasoactive Intestinal Peptide

In adult coeliac sprue patients, intraduodenal instillation of a hypertonic glucose-citric acid solution may release gastrointestinal hormones of the proximal (secretin, gastric inhibitory polypeptide, motilin) and distal (enteroglucagon, neurotensin) small intestine and, indirectly, of the pancreas (glucagon, insulin, pancreatic polypeptide). Characteristic plasma hormone profiles can be measured radioimmunologically. The reduced secretin response reflects most sensitively the impaired function of the small intestine. Exposure of the distal small bowel to greater nutrient loads leads to markedly and constantly elevated plasma levels of enteroglucagon. Only after complete functional as well as morphologic mucosal restoration, the increased enteroglucagon concentrations return to normal. On the other hand, the neurotensin response, which is likewise enhanced in active coeliac sprue, is sooner corrected during treatment. Gastrointestinal hormones with predominantly neurocrine action, such as vasoactive intestinal peptide (VIP), are apparently less affected by coeliac sprue. Pancreatic hormones are involved in the pathophysiology of sprue only indirectly, e. g. via diminished glucose absorption.

Topics: Adult; Blood Glucose; Celiac Disease; Female; Gastric Inhibitory Polypeptide; Gastrins; Gastrointestinal Hormones; Glucagon; Glucagon-Like Peptides; Humans; Insulin; Insulin Secretion; Male; Middle Aged; Motilin; Neurotensin; Pancreatic Polypeptide; Secretin; Vasoactive Intestinal Peptide