List of Open Access Medical Journal - BJSTR Journal

Abstract

#Carcinoid syndrome, characterized by symptoms such as diarrhea, flushing or #wheezing, is caused by an excessive production of serotonin. Diarrhea and excessive bowel movement negatively affects the quality of life of these patients. #Somatostatin analogues are efficacious but cannot optimally control symptoms. A review of clinical efficacy data in supporting the therapeutic indication for orphan drug designation is presented focused on the new approved drug, telotristat ethyl, an inhibitor of the #tryptophan hydroxylase type I enzyme involved in the synthesis of serotonin. By depleting serotonin in the gastrointestinal tract, telotristat ethyl interrupts the pathological chain process of the diarrhea and demonstrated efficacy in patients with carcinoid syndrome. Carcinoid tumors are a subset of functional #neuroendocrine tumors which can develop in lungs, thymus, small intestine, ovary, thyroid glands [1]. The carcinoid syndrome, caused by an excessive production of serotonin, occurs in less than 10% of the neuroendocrine tumors and manifest with typical symptoms of diarrhea, abdominal pain and flushing. These tumors can also secrete other hormones such as growth hormone, insulin, glucagon, #vasoactive intestinal peptide or #parathyroide hormone related peptide. The incidence is increasing, in part due to accessibility to diagnosis and on physician awareness about these forms of tumors [1], but also to environmental factors, such as smoking or asbestos exposure [2-4] that have been recently linked to the development of the neuroendocrine tumors. The diagnosis is based on symptoms, biological markers (hormones, serotonin or metabolites), imaging identification and histologic confirmation. The WHO classification requires histology, mitotic count and proliferation index determined by the percent of cells staining positively with a monoclonal antibody directed against a nuclear antigen in the proliferating cells (KI-67/MIB-1) [5].

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Novel Therapy of the #CarcinoidSyndrome Related Diarrhea by Marina Ruxandra Oțelea in BJSTR