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Tachykinins in endocrine tumors and the carcinoid syndrome

Janet L Cunningham1, Eva T Janson, Smriti Agarwal

  • 1Departments of Medical Sciences Genetics and Pathology, University Hospital, SE 751 85 Uppsala, Sweden. janet.cunningham@medsci.uu.se

European Journal of Endocrinology
|June 6, 2008
PubMed
Abstract

Insights

Tachykinin (TK) is synthesized in serotonin-producing tumors. Elevated plasma TK levels correlate with carcinoid syndrome symptoms like diarrhea and flush, independent of other markers.

Area of Science:

  • Endocrinology
  • Oncology
  • Gastroenterology

Background:

  • Neuroendocrine tumors, particularly metastatic ileocecal serotonin-producing carcinoid tumors (MSPCs), can cause debilitating symptoms like diarrhea and flush.
  • The role of tachykinin (TK) in these symptoms is not fully understood, though it is known to be involved in neurotransmission and inflammation.

Purpose of the Study:

  • To investigate TK expression in endocrine tumors using a novel antibody.
  • To determine the association between plasma TK levels and the severity of diarrhea and flush in patients with MSPCs.

Main Methods:

  • Immunohistochemistry was used to assess TK, serotonin, and chromogranin A (CgA) immunoreactivity in tumor tissues.
  • Plasma TK (P-TK), CgA, and urinary 5-hydroxyindoleacetic acid (U-5HIAA) levels were measured in MSPC patients and correlated with symptom frequency.

Main Results:

  • TK expression was observed in all serotonin-producing tumors, including MSPCs, but not in other endocrine tumors.
  • Elevated P-TK, P-CgA, and U-5HIAA levels were associated with daily episodes of flush or diarrhea.
  • P-TK levels showed an independent correlation with daily diarrhea, irrespective of U-5HIAA and CgA levels.

Conclusions:

  • TK synthesis occurs in serotonin-producing tumors, and plasma TK levels are significantly correlated with flush and diarrhea in MSPC patients.
  • This study is the first to report an independent correlation between P-TK and carcinoid diarrhea, challenging the sole attribution to serotonin.
  • Further research into TK may reveal new therapeutic strategies for carcinoid syndrome.

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