Effect of the Somatostatin Analogue Sandostatin (SMS 201–995) on Gastrointestinal, Pancreatic and Biliary Function and Hormone Release in Normal Men

Abstract

The effect of the long-acting somatostatin analogue Sandostatin (SMS 201–995) on intestinal absorption and propagation (mouth-to-caecum transit time; MCTT), on pancreatic secretion and on gall bladder contraction after direct (secretin-pancreozymin test) and indirect stimulation (Lundh meal), and on meal-induced responses of seven gastrointestinal regulatory peptides has been investigated. In a double-blind cross-over study, 9 healthy volunteers completed two 7-day periods with subcutaneous injections of either placebo or 25 μg SMS 201–995 twice daily. Mean faecal fat excretion was increased to 19.2 g/ day and MCTT was three times longer during the SMS period. After duodenal infusion of a mixture containing D-galactose, D-xylose and triglycerides, SMS 201–995 significantly reduced the serum concentrations of D-galactose but increased serum levels of D-xylose. After 6 days of pretreatment, SMS 201–995 completely suppressed duodenal trypsin, lipase and bilirubin increases in response to endogenous stimulation by a Lundh meal. Concomitantly, cholecystokinin (CCK) release and gall bladder contraction were almost abolished. Compared with placebo, SMS 201–995 significantly diminished pancreatic amylase, trypsin and lipase output after stimulation with CCK, while the secretion of fluid and bicarbonate in response to secretin was unchanged. This inhibition of enzyme response was significantly more marked after a single injection of the analogue than after pretreatment for 7 days and did not reach the level of exocrine pancreatic insufficiency. CCK-induced gall bladder contraction was significantly inhibited by a single dose of 25 μg SMS 201–995 but not after 7 days of pretreatment with the somatostatin analogue.

Differential effect of saturated and polyunsaturated fatty acids on hepatic glucose metabolism in humans

“…Consequently, in the present studies we infused either palm oil or safflower oil via enteral feeding tube. Because lipid absorption from the proximal small intestine requires CCK, and somatostatin is a potent inhibitor of CCK as well as peristalsis (35), initiation of the somatostatin infusion was delayed for 120 min. This method results in an increase in plasma FFA concentration within the physiological range to levels that have previously been shown to inhibit hepatic insulin action in man (8,22).…”

Treatment of Gastrointestinal Endocrine Tumours with Interferon-α and Octreotide

“…Octreotide has been shown to have similar effects already at the low dose of 25 pg daily (19). Since IFN-a does not have this dramatic effect on hormone secretion, the rate of subjective improvement was much lower after IFN-c( than after octreotide.…”

Canadian practice patterns for pancreaticoduodenectomy

“…Octreotide and other somatostatin analogues function to inhibit the release of endocrine and exocrine pancreatic secretions, 25 a process that effectively reduces the volume of secretions and may decrease the incidence of anastomotic leaks and pancreatic fistulas. The precise role of prophylactic octreotide remains controversial; a number of recent studies have reported inconsistent effects on postoperative complications, yet a Cochrane review on the subject concluded that perioperative complications were reduced following somatostatin analogue treatment during pancreatic resections.…”