Circulating tachykinins (substance p, neurokinin a, neuropeptide k) and the carcinoid flush

J. M. Conlon, C. F. Deacon, G. Richter, F. Stöckmann, W. Creutzfeldt

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Antisera of defined regional specificity have been used to measure the concentration of substance P-like immunoreactivity (SP-LI) and neurokinin A-like immunoreactivity (NKA-LI) during a meal-induced flush in 10 patients with metastatic carcinoid tumours. Although all patients flushed, NKA-LI levels in five patients and SP-LI in six patients were not elevated relative to healthy subjects (NKA-LI, < 3 pg/ml; SP-LI, < 10 pg/ml) both in the fasted state and after food. In the patients with elevated basal plasma tachykinin levels, increases in NKA-LI and SP-LI after food were erratic and did not correspond to a defined digestive phase or the occurrence of the flush. Chromatographic analysis of plasma demonstrated the presence of neuropeptide K and neurokinin A, and the detection of COOH-terminal fragments of substance P is consistent with the higher levels of circulating SP-LI measured with a COOH-terminally directed antiserum compared with an NH,-terminally directed antiserum. Subcutaneous injection of the somatostatin analogue SMS 201-995 (50 μg) alleviated symptoms of flush in two of three patients but only partially suppressed NKA-LI and SP-LI concentrations. It is concluded that circulating tachykinins cannot be solely responsible for the meal-induced carcinoid flush.

Original languageEnglish
Pages (from-to)97-105
Number of pages9
JournalScandinavian Journal of Gastroenterology
Issue number1
Publication statusPublished (in print/issue) - 1987


  • Carcinoid flush
  • Neurokinin A
  • Neuropeptide K
  • Serotonin
  • Somatostatin analogue
  • Substance P


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