Secretin

Secretin (ChiRhoStim) — Synthetic Human Secretin for Diagnostic Use

Evidence & Status

  • FDA Approved
  • Strong Human Evidence
  • Established

At a Glance

A 27-amino-acid intestinal hormone used clinically as synthetic human secretin (ChiRhoStim) for diagnostic procedures involving pancreatic secretion, gastrin secretion, and ERCP. Controlled clinical trials did not demonstrate efficacy for autism.

Plain English

Secretin is a natural intestinal signal that prompts the pancreas to release bicarbonate-rich fluid when food and acid enter the small intestine. In clinical care, synthetic human secretin is used for specific diagnostic procedures rather than as a long-term treatment. Early interest in secretin for autism was followed by controlled trials and systematic reviews that did not find meaningful clinical benefit.

Overview

Secretin is a 27-amino-acid peptide hormone produced by the duodenum in response to nutrients and gastric acid. Synthetic human secretin used clinically is identical in amino-acid sequence to endogenous human secretin. By activating secretin receptors on pancreatic ductal cells, it opens CFTR channels and promotes bicarbonate-rich pancreatic secretion. Its established clinical role is diagnostic, not chronic therapeutic administration: ChiRhoStim is used to stimulate pancreatic secretions for diagnostic testing, stimulate gastrin secretion to aid diagnosis of gastrinoma, and facilitate identification of structures during ERCP.

Research Summary

Secretin has established human clinical use as a diagnostic agent. Current ChiRhoStim labeling supports stimulation of pancreatic secretions, including bicarbonate, to aid diagnosis of exocrine pancreas dysfunction; stimulation of gastrin secretion to aid diagnosis of gastrinoma; and stimulation of pancreatic secretions to facilitate ERCP. Its established use is diagnostic rather than chronic therapeutic. Historical interest in autism was not supported by controlled evidence: a double-blind, placebo-controlled trial of synthetic human secretin did not demonstrate improvement versus placebo, and a Cochrane systematic review concluded that randomized controlled trials did not show improvement in core autism-spectrum-disorder features. Multiple randomized controlled trials and systematic reviews failed to demonstrate clinical benefit for autism.

Research Areas

  • Pancreatic exocrine function
  • Gastrinoma diagnosis
  • ERCP facilitation
  • GI hormone biology
  • Autism — historical research; controlled clinical trials did not demonstrate efficacy

Safety & Risks

Serious Risks

  • Diagnostic testing limitation: anticholinergic drugs may cause a hyporesponse to ChiRhoStim stimulation testing; discontinue anticholinergic drugs at least five half-lives before testing.
  • Test interpretation precaution: H2-receptor antagonists or proton-pump inhibitors may cause increased gastrin secretion and falsely suggest gastrinoma; discontinue H2-receptor antagonists at least two days before testing and follow the individual PPI prescribing information.
  • Diagnostic testing limitation: alcoholic or other liver disease may cause a hyperresponse to ChiRhoStim and mask coexisting pancreatic disease; consider additional testing and clinical assessment.

Reported Side Effects

  • Nausea
  • Vomiting
  • Flushing
  • Upset stomach
United States
FDA-approved as ChiRhoStim (synthetic human secretin) to stimulate pancreatic secretions, including bicarbonate, to aid diagnosis of exocrine pancreas dysfunction; stimulate gastrin secretion to aid diagnosis of gastrinoma; and facilitate identification of the ampulla of Vater and accessory papilla during ERCP.
United Kingdom
Current regulatory status not verified in this remediation; no availability or approval claim is made.
Australia
Current regulatory status not verified in this remediation; no availability or approval claim is made.
Canada
Current regulatory status not verified in this remediation; no availability or approval claim is made.

Citations & Sources