Vasoactive intestinal peptide (= VIP) is a neurotransmitter, widely distributed through the central and peripheral nervous system with the highest concentration occurring in the submucosal postganglionic intrinsic nerves of the intestinal tract.
Normally VIP has a low blood concentration and does not change with meals.
What are the functions of Vasoactive intestinal peptide?
VIP is considered a hormone and is found in the pancreas, intestine, and central nervous system. It has many functions in the body, such as:
→ functions as a neuromodulator and neurotransmitter
→ helping to control the secretion of water, salts, enzymes, and gastric acid during digestion.
→ regulates smooth muscle activity, epithelial cell secretion, and blood flow in the gastrointestinal tract
→ being a potent vasodilator [open (dilate) blood vessels]
→ has effects on the immune system and the central nervous system.
→ it functions as a neurohormone and paracrine mediator, being released from nerve terminals and acting locally on receptor-bearing cells.
Certain tumors in the pancreas make large amounts of vasoactive intestinal peptide. Vasoactive intestinal polypeptide secreting tumors (VIPomas) are very rare pancreatic neuroendocrine tumors (PNETs) associated with profuse diarrhea. The VIPoma syndrome is also known as Verner-Morrison syndrome, watery diarrhea, hypokalemia, and hypochlorhydria or achlorhydria (WDHA) syndrome, and pancreatic cholera syndrome. VIPomas are functional neuroendocrine tumors that secrete excessive amounts of VIP. VIPoma tumors present as sporadic, solitary pancreatic neoplasias (= abnormal mass of tissue that forms when cells grow and divide more than they should or do not die when they should).
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Values >75 pg/mL may indicate presence of enteropancreatic tumor causing hypersecretion of vasoactive intestinal polypeptide (VIP).
Values >200 pg/mL are strongly suggestive of VIP producing tumors (VIPoma).
Oversecretion of VIP from VIPomas is responsible for the rare Verner-Morrison or WDHA (watery diarrhea, hypokalaemia, achlorhydria) syndrome. It is characterized by profuse watery diarrhea, dehydration, hypotension, flushing, intestinal ileus, hypokalaemia, achlorhydria, hypomagnesaemia and metabolic acidosis. Hyperglycaemia and hypercalcaemia can also occur. While achlorhydria or hypochlorhydria distinguishes this diarrhoeal syndrome from gastrinoma, absence of this feature in some VIPoma patients is possible.
Pancreatic VIPomas (90%) are commonly located in the body and tail of pancreas while extra-pancreatic VIPomas occur in the autonomic nervous system.
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