Secretin human

Summary

Secretin human is a synthetic form of the naturally occurring gastrointestinal peptide hormone used diagnostically to stimulate pancreatic secretion for assessment of exocrine pancreatic function and for facilitation of endoscopic retrograde cholangiopancreatography (ERCP). It is a 27-amino-acid peptide identical in sequence to endogenous human secretin.

Mechanism of Action

Binds to secretin receptors (SCTR) on pancreatic ductal cells and biliary epithelium, stimulating bicarbonate-rich fluid secretion from the pancreas; also inhibits gastric acid secretion and gastrin release, and augments cholecystokinin-stimulated enzyme secretion.

Routes of Administration

Goals & Uses

• Pancreatic exocrine function testingDiagnosticHigh
• Autism spectrum disorder (investigational)Neurological / InvestigationalLow
• Diagnosis of gastrinoma (Zollinger-Ellison syndrome)DiagnosticHigh
• Facilitation of ERCPDiagnostic / ProceduralHigh
• Magnetic resonance cholangiopancreatography (MRCP) enhancementDiagnostic / ImagingModerate

Contraindications

• Vagotomy or inflammatory bowel disease affecting duodenumGastrointestinal / SurgicalModerate
• Acute pancreatitisGastrointestinalHigh
• Hypersensitivity to secretin or any excipientsAllergy / ImmunologicHigh

Adverse Effects

• Anaphylaxis / hypersensitivityImmunologicRare
• HypotensionCardiovascularRareLow blood pressure
• FlushingVascularUncommonWarmth and redness of the skin
• NauseaGastrointestinalCommonFeeling of sickness or urge to vomit
• Abdominal discomfort / crampingGastrointestinalUncommon
• BradycardiaCardiovascularRare

Drug Interactions

• Proton pump inhibitors (PPIs)Low
• Anticholinergics (e.g., atropine)Moderate
• H2-receptor antagonistsLow

Population Constraints

• PregnancyReproductive SafetyRelative
• Pediatric patientsAgeRelative
• Patients with known allergy to porcine secretinAllergy / ImmunologicRelative
• Renal or hepatic impairmentOrgan DysfunctionRelative

Regulatory Status

• European UnionUnknownSecretin products have had various approval histories in EU member states; human synthetic secretin availability varies by country. Porcine secretin (Secretin-Ferring) was historically available in some EU countries.
• United StatesApprovedApproved: Stimulation of pancreatic secretion for diagnosis of exocrine pancreatic dysfunction, Stimulation of gastrin secretion for diagnosis of gastrinoma (Zollinger-Ellison syndrome), Facilitation of identification of the ampulla of Vater and accessory papilla during endoscopic examinationApproved by the FDA under the brand name ChiRhoStim. Original NDA approval. Human synthetic secretin replaced porcine secretin (Secretin-Ferring) which was withdrawn.
• United KingdomUnknownAvailability and approval status in the UK post-Brexit is not well-documented for human synthetic secretin specifically.

Approved by the FDA as ChiRhoStim (human secretin) for diagnostic use. Also used to aid in the diagnosis of gastrinoma (Zollinger-Ellison syndrome) via the secretin stimulation test.

Evidence & Sources

No sources recorded yet.