Abstracts
Colon Cancer and Digestive Enzymes
Colon cancer
Glutamine supplementation has been advocated for patients requiring parenteral nutritional support. However, the direct effect of glutamine on neoplastic cells is poorly understood. We therefore investigated the effects of glutamine on the proliferation, differentiation, and cell-matrix interactions of two human colon carcinoma cell lines (Caco-2 and SW620) adapted to glutamine-free media. Glutamine inhibited the expression of all four digestive enzymes with maximal inhibition ranging from 10 to 40% (P < 0.05 for all). This raises the possibility that nutritional supplementation with glutamine may be deleterious in patients with cancer.
Turowski-GA; Rashid-Z; Hong-F; Madri-JA; Basson-MD: Glutamine modulates phenotype and stimulates proliferation in human colon cancer cell lines. Cancer-Res. 1994 Nov 15; 54(22): 5974-80.
Pancreatitis & Digestive Enzymes
Pancreatitis
Acute pancreatitis is caused by the activation of digestive enzymes in the pancreas and a possible treatment, therefore, is the inhibition of enzyme secretion. This approach is somewhat controversial, however, as it is not clear whether pancreatic secretion continues to occur during the course of acute pancreatitis. A meta analysis of six individual studies in which somatostatin was given for acute pancreatitis showed that somatostatin significantly reduces mortality. A further study showed a significant reduction in patient controlled analgesics in patients treated with octreotide compared with controls.
Pain is the important clinical symptom of chronic pancreatitis, possibly resulting from an increased intraductal pressure during secretion.
The effect on pain of the inhibition of pancreatic secretion by octreotide has been investigated in two studies. One showed no significant reduction in pain after treatment with octreotide for three days. In the other, in which octreotide was used for three weeks, significantly less pain and analgesic use was recorded during octreotide treatment than during placebo. The most common complication of chronic pancreatitis is the formation of pseudocysts. There is some evidence that octreotide may be useful in their treatment.
Buchler-MW; Binder-M; Friess-H: Role of somatostatin and its analogues in the treatment of acute and chronic pancreatitis. Gut. 1994; 35(3 Suppl): S15-9
The pathophysiology of acute pancreatitis remains controversial. Activation of digestive enzymes in the pancreas may play an important role in the course of this disease. Therefore, the inhibition of enzyme secretion may be a possible treatment concept. However, it is not clear whether pancreatic secretion continues during the course of acute pancreatitis. In the present paper experimental and clinical studies are reviewed to evaluate the effect of somatostatin and octreotide treatment in acute pancreatitis.
Buchler-MW; Binder-M; Friess-H; Malfertheiner-P: Potential role of somatostatin and octreotide in the management of acute pancreatitis. Digestion. 1994; 55 Suppl 1: 16-9
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