Pancreatic cholera

Thiosulfate cyanide sulfurtransferase symmetry in 78 TTiiouridine 234 Three-dimensional structures of aconitase 689 adenylate kinase 655 aldehyde oxido-reductase 891 D-amino acid oxidase 791 a-amylase, pancreatic 607 aspartate aminotransferase 57,135 catalytic intermediates 752 aspartate carbamyltransferase 348 aspartate chemoreceptor 562 bacteriophage P22 66 cadherin 408 calmodulin 317 carbonic acid anhydrase I 679 carboxypeptidase A 64 catalase 853 cholera toxin 333, 546 chymotrypsin 611 citrate synthase 702, 703 cutinase 134 cyclosporin 488 cytochrome c 847 cytochrome c peroxidase 849 dihydrofolate reductase 807 DNA 214, 223,228,229, 241 DNA complex... 

Severe complications connected with cholera (or combined) immunization are extremely rare and the causal relation is always doubtful. However, when they do occur they constitute a contraindication to further administration. There are occasional reports of neurological and psychiatric reactions (SED-8, 706) (SEDA-1, 246), Guillain-Barre syndrome (SEDA-1, 246), myocarditis (154,155), myocardial infarction (SEDA-3, 261), a syndrome similar to immune complex disease (156), acute renal insufficiency accompanied by hepatitis (157), and pancreatitis (158). 

Gatt DT. Pancreatitis following monovalent typhoid and cholera vaccinations. Br J Clin Pract 1986 40(7) 300-1. 

Possible applications are extensive and include the treatment of pain (e.g. in burns), inflammation, neurogenic inflammation, oedema (including cerebral oedema and angio-oedema), shock (especially septic shock, probably with B, as well as B2 antagonists), rhinitis and asthma, pancreatitis and defective ion transport, such as cholera, Crohn s disease and cystic fibrosis, and chronic inflammatory conditions such as rheumatoid and osteoarthritis. 

Octreotide blocks the release of serotonin and many other active peptides and has been effective in controlling diarrhea and flushing. It is reported to have direct inhibitory effects on intestinal secretion and stimulatory effects on intestinal absorption. Non-gastrin-secreting adenomas of the pancreas are tumors associated with profuse watery diarrhea. This condition has been referred to as Verner-Morrison syndrome, WDHA (watery diarrhea, hypokalemia, and achlorhydria) syndrome, pancreatic cholera, watery diarrhea syndrome, and VIPoma. Excessive secretion of VIP from a retroperitoneal or pancreatic tumor produces most of the clinical features. Excessive VIP is isolated in about half of patients, along with numerous other peptide hormones (peptide histidine methionine [PHM], serotonin,... 

Thus, lAP is, like diphtheria and cholera toxins, a protein toxin with an A-B structure. The holotoxin is bound to particular sites on the cell surface via its B-oligomer moiety as the first step of its interaction with mammalian cells. The A-protomer (or holotoxin itself) is then inserted to the plasma membrane traversing the lipid bilayer gradually. This slow process of the entrance of the toxin molecule is reflected in a definite lag time invariably preceding the onset of the action of lAP on intact cells as analyzed with rat pancreatic islets by kinetic and immunological approaches [25]. The A-protomer is finally activated by certain processing enzyme(s) inside the membrane to catalyze ADP-ribosylation of the target membrane protein with intracellular NAD as substrate. 

---