Efficacy of the Natural Clay, Calcium Aluminosilicate Anti-Diarrheal, in Reducing Medullary Thyroid Cancer–Related Diarrhea and Its Effects on Quality of Life: A Pilot Study

Dadu, Ramona; Hu, Mimi I.; Cleeland, Charles S.; Busaidy, Naifa L.; Habra, Mouhammed Amir; Waguespack, Steven G.; Sherman, Steven I.; Ying, Anita K.; Fox, Patricia S.; Cabanillas, Maria E.

doi:10.1089/thy.2015.0166

Cited by 22 publications

(12 citation statements)

References 24 publications

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“…In this respect, studies that characterize the phenotype of CaSR −∕− mice (Rey O et al, 2012 ; Macleod, 2013b ; Cheng et al, 2014 ) or associate SNPs in CaSR for diarrheal conditions (Ho et al, 2010 ; Romero et al, 2015 ) would be useful. Nonetheless, preliminary data from animals (Bovee-Oudenhoven et al, 1996 , 1997 ; Bovee Oudenhoven et al, 1997 , 1999 ) and clinical trials on humans (Bovee-Oudenhoven et al, 2003 ; Cheng et al, 2013 ; Dadu et al, 2015 ) using calcium or other CaSR ligands indicate that activation of this nutrient sensing receptor in vivo does reduce symptoms of infectious diarrheas (also see recent review by Cheng, 2016 ).…”

Section: Casr and Intestinal Absorption And Secretionmentioning

confidence: 99%

The Extracellular Calcium-Sensing Receptor in the Intestine: Evidence for Regulation of Colonic Absorption, Secretion, Motility, and Immunity

et al. 2016

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Different from other epithelia, the intestinal epithelium has the complex task of providing a barrier impeding the entry of toxins, food antigens, and microbes, while at the same time allowing for the transfer of nutrients, electrolytes, water, and microbial metabolites. These molecules/organisms are transported either transcellularly, crossing the apical and basolateral membranes of enterocytes, or paracellularly, passing through the space between enterocytes. Accordingly, the intestinal epithelium can affect energy metabolism, fluid balance, as well as immune response and tolerance. To help accomplish these complex tasks, the intestinal epithelium has evolved many sensing receptor mechanisms. Yet, their roles and functions are only now beginning to be elucidated. This article explores one such sensing receptor mechanism, carried out by the extracellular calcium-sensing receptor (CaSR). In addition to its established function as a nutrient sensor, coordinating food digestion, nutrient absorption, and regulating energy metabolism, we present evidence for the emerging role of CaSR in the control of intestinal fluid homeostasis and immune balance. An additional role in the modulation of the enteric nerve activity and motility is also discussed. Clearly, CaSR has profound effects on many aspects of intestinal function. Nevertheless, more work is needed to fully understand all functions of CaSR in the intestine, including detailed mechanisms of action and specific pathways involved. Considering the essential roles CaSR plays in gastrointestinal physiology and immunology, research may lead to a translational opportunity for the development of novel therapies that are based on CaSR's unique property of using simple nutrients such as calcium, polyamines, and certain amino acids/oligopeptides as activators. It is possible that, through targeting of intestinal CaSR with a combination of specific nutrients, oral solutions that are both inexpensive and practical may be developed to help in conditioning the gut microenvironment and in maintaining digestive health.

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Section: Casr and Intestinal Absorption And Secretionmentioning

confidence: 99%

The Extracellular Calcium-Sensing Receptor in the Intestine: Evidence for Regulation of Colonic Absorption, Secretion, Motility, and Immunity

et al. 2016

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“…General approaches to the management of diarrhea include measures such as avoidance of foods that may cause bowel movements . Consumption of grated oxidized apples , 90% cocoa chocolate, carob powder , clay and dried blueberries (personal communication) may help reduce bowel movements, and probiotics have been shown to reduce the incidence of diarrhea induced by chemotherapy . Several drugs, such as loperamide, may also be used to slow intestinal transit and thus reduce the risk of diarrhea .…”

Section: Resultsmentioning

confidence: 99%

Management of Adverse Events Associated with Cabozantinib Therapy in Renal Cell Carcinoma

Schmidinger

Danesi

2017

The Oncologist

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Cabozantinib leads to improved survival outcomes in renal cell carcinoma patients compared with everolimus. However, management of the adverse event profile is crucial to achieve optimum adherence and outcomes with the use of cabozantinib. This review aims to provide appropriate guidance that will minimize the impact of adverse events and help to maximize the utility of this agent in patients with advanced renal cell carcinoma.

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“…Alawneh et al [ 14 ] administered glycopyrrolate in a patient with octreotide-resistant diarrhea due to MTC and noted improvement. Dadu et al [ 15 ] recently studied the effect of calcium aluminosilicate antidiarrheal drug in 7 patients with metastatic MTC-associated diarrhea and concluded that 5 of the 7 patients responded to this treatment.…”

Section: Discussionmentioning

confidence: 99%

Diarrhea as an Initial Presentation in Patients with Medullary Thyroid Cancer: Delaying the Diagnosis

Shakir

Spiro

Vinh

et al. 2020

Case Rep Gastroenterol

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Tumoral secretion of various molecular factors, such as calcitonin (Ct), can cause diarrhea in patients with medullary thyroid cancer (MTC). We report 3 patients (age 26-38 years, serum Ct levels ranging from 2,890 to 52,894 ng/L) with chronic diarrhea, and the diagnosis of MTC was delayed. Diarrheal symptoms improved after thyroid surgery. Two patients with elevated Ct had no diarrhea. The link between tumor humoral secretion and diarrhea is not well established in patients with MTC. Diarrhea is more common in patients with metastatic disease and improves after resection of the tumor. Diarrhea may result from elevated circulating levels of Ct or other substances, such as prostaglandins or serotonin. Other proposed mechanisms include decreased absorption in the colon secondary to gastrointestinal motor disturbances. In conclusion, MTC should be considered when evaluating chronic diarrhea.

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Efficacy of the Natural Clay, Calcium Aluminosilicate Anti-Diarrheal, in Reducing Medullary Thyroid Cancer–Related Diarrhea and Its Effects on Quality of Life: A Pilot Study

Abstract: CASAD is a promising strategy for treatment of MTC-related diarrhea. In this small pilot study, improvements in frequency and quality of diarrhea as well as QOL were noted. Further studies in this population are warranted.

Cited by 22 publications

References 24 publications

The Extracellular Calcium-Sensing Receptor in the Intestine: Evidence for Regulation of Colonic Absorption, Secretion, Motility, and Immunity

The Extracellular Calcium-Sensing Receptor in the Intestine: Evidence for Regulation of Colonic Absorption, Secretion, Motility, and Immunity

Management of Adverse Events Associated with Cabozantinib Therapy in Renal Cell Carcinoma

Diarrhea as an Initial Presentation in Patients with Medullary Thyroid Cancer: Delaying the Diagnosis

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