Elevated Plasma and Tissue Levels of Vasoactive Intestinal Polypeptide in the Watery-diarrhea Syndrome Due to Pancreatic, Bronchogenic and Other Tumors

The actions of the vasoactive intestinal polypeptide make it a potential candidate for mediating certain manifestations of the watery-diarrhea syndrome. Peptide levels were measured by radioimmunoassay in 25 controls and 30 patients with chronic watery diarrhea. Plasma levels were too low to measure (smaller 200 pg per milliliter) in 22 of the controls, averaging 79 plus or minus 64 pg per milliliter (S.D.). Levels were elevated in 26 of 28 plasma samples (5.1 plus or minus 2.5 ng per milliliter), and in each of 13 tissue extracts (5.1 plus or minus 10.9 mug per gram); in all, 28 patients had elevated levels in plasma or tissue or both. Thirteen patients had pancreatic islet-cell adenoma, four islet-cell hyperplasia, five bronchogenic carcinoma, and one each pheochromocytoma and ganglioneuroblastoma. The findings indicate that the peptide is a probable mediator of the watery-diarrhea syndrome, that the syndrome may result from a variety of non-pancreatic tumors, and that this or a related peptide may also be secreted by these tumors.