Metoclopramide stimulates catecholamine- and granin-derived peptide secretion from pheochromocytoma cells through activation of serotonin type 4 (5-HT4) receptors

Section: European Journal Of Endocrinologymentioning

confidence: 99%

Multiple aberrant hormone receptors in Cushing's syndrome

Ghorayeb

Bourdeau

Lacroix

2015

“…Although metoclopramide is an effective prokinetic, its use is contraindicated in patients with catecholamine-secreting MPPs. In these patients, metoclopramide and serotonin agonists may precipitate a catecholamine crisis (30).…”

Section: Control Of Hormone-and Tumor-related Symptomsmentioning

confidence: 99%

THERAPY OF ENDOCRINE DISEASE: Treatment of malignant pheochromocytoma and paraganglioma

Baudin

Habra

Deschamps

et al. 2014

100

Metastatic pheochromocytomas and paragangliomas (MPPs) present clinicians with three major challenges: scarcity, complexity of characterization, and heterogeneous behavior and prognosis. As with the treatment for all neuroendocrine tumors, the control of hormonal symptoms and tumor growth is the main therapeutic objective in MPP patients. A significant number of MPP patients still die from uncontrolled hormone secretion. In addition, the management of MPPs remains palliative. Steps forward include proper characterization of MPP patients at large cancer referral centers with multidisciplinary teams; improved strategies to stratify patients prognostically; and implementation of trials within national and international networks. Progress in the molecular characterization and staging of MPPs constitutes the basis for significant treatment breakthroughs.

“…A potential limitation of this study might be the lack of specificity of metoclopramide as a D 2 receptor dopaminergic blocker as this drug, although initially regarded as the prototype of D 2 receptor-selective antagonists, was thereafter found not to be a pure drug (18,19). It displays submicromolar affinity for D 2 and D 3 receptors, but micromolar affinity also for D 1 , D 4 , and D 5 .…”

Section: Discussionmentioning

confidence: 93%

Subtyping of primary aldosteronism by adrenal vein sampling: effect of acute D2 receptor dopaminergic blockade on adrenal vein cortisol and chromogranin A levels

Seccia¹,

Miotto²,

Toni³

et al. 2011

Background: Adrenal vein sampling (AVS) is the gold standard for identifying the surgically curable forms of primary aldosteronism. Dopamine modulates adrenocortical steroidogenesis and tonically inhibits aldosterone secretion via D 2 receptor. However, whether it could also affect the release of cortisol and chromogranin A (ChA), which can be used to assess the selectivity of AVS, is unknown. Objective: To investigate whether metoclopramide increased the release of cortisol and ChA and could thereby improve assessment of the selectivity at AVS. Design and methods: We investigated the effect of acute D 2 antagonism with metoclopramide on cortisol and ChA release from the adrenal gland by comparing the adrenal vein and infrarenal inferior vena cava (IVC) hormone levels at baseline and after metoclopramide administration in 34 consecutive patients undergoing AVS. Results: Metoclopramide increased plasma aldosterone in the IVC (P!0.00001) and in the adrenal vein blood (P!0.002) but failed to increase plasma cortisol concentration or ChA levels. Therefore, it did not increase the selectivity index based on the measurement of either hormone. Conclusions: This study shows that the release of cortisol and ChA is not subjected to tonic D 2 dopaminergic inhibition. Therefore, these findings lend no evidence for the usefulness of acute metoclopramide administration for enhancing the assessment of the selectivity of blood sampling during AVS with the use of either cortisol or ChA assay.