Somatostatin and Octreotide on the Treatment of Acute Pancreatitis - Basic and Clinical Studies for Three Decades

Jing      Li; Rui      Wang; Chengwei      Tang

doi:10.2174/138161211796196936

Abstract

The finding that somatostatin (SST) or its analogue, octreotide caused a dose-dependent reduction in exocrine pancreatic secretions triggered their research as therapeutic options for acute pancreatitis (AP), a life-threatening illness. However, the accumulative clinical trials of SST or octreotide in AP treatment present the controversial results. The insufficient secretory capacity of acinar cells in AP patients also queries the validity of traditional assumption on the effects of SST and octreotide. This reviewer updates the current pharmacological concepts of SST and octreotide in treatment of AP and the clinical strategies of their application. The impressive inhibitive effects on the massive inflammatory injury via the several signal pathways make SST as an important anti-inflammatory peptide. Furthermore, endocrine SST may decrease the sphincter tone of Oddi (SO) by its potential role on the neurocrine of SST in SO. Therefore, it should be rational that exogenous supplement of SST or octreotide for AP patients due to the plasma level of SST during AP is usually lower than that of normal. In accordance with these findings, the optimal stage of SST or octreotide administration, application in high risk population, the cost-effective dosage or duration as well as the design of suitable clinical outcomes would be the interesting topics of translational medical research for both basic scientists and clinicians.

Keywords: Acute pancreatitis, somatostatin, octreotide, nuclear factor kappa B, sphincter of Oddi, obesity, chronic alcoholics, APACHE II score, necrosis, trypsinogen, trypsin, hydrolase, exocrine, nasogastric, autophagy, secretagogues, acinar cells, zymogen