Search

Two dogs were equipped with gastric and duodenal cannulas permitting quantitative collection of pure pancreatic juice. Two series of experiments were performed: 1) collection through a short catheter, length 35 cm, volume 0.3 ml, and internal diameter 1.0 mm, and 2) collection through a long catheter used for duodenoscopic cannulation in man, length 110 cm, volume 1.7 ml, and internal diameter 1.0 mm at the tip and 1.4 mm in the other part of the catheter. After a basal period of 30 min the secretion was stimulated with secretin in the doses 0.1, 0.5, and 2.0 clinical units/kg/h, each dose being infused over a period of 30 min. With the long catheter the dose-response curve for fluid and bicarbonate was shifted to the right. The basal secretion of fluid was depressed 40%; with increasing secretory rates the depression was less pronounced. No significant depression of the bicarbonate concentration was seen. The protein secretion was insignificantly reduced.

To assess whether sulfated gastrin contributes to the cholecystokinetic and pancreozymic activity of plasma in humans, 8 healthy subjects on separate days received a mixed meal, graded i.v. infusions of synthetic human tyrosine-O-sulfated gastrin 17 (10.9, 32.7, and 98.1 pmol/kg X h), which was compared with nonsulfated gastrin 17 (12.2, 36.6, and 109.8 pmol/kg X h) and O-sulfated cholecystokinin-octapeptide (5.5, 16.5, and 49.5 pmol/kg X h). Gallbladder volumes were measured by ultrasonography, and the concentrations of gastrin and cholecystokinin in the circulation were determined by specific radioimmunoassays. Neither of the gastrins induced changes in gallbladder volume at serum concentrations occurring postprandially, whereas cholecystokinin-octapeptide produced a significant reduction in gallbladder volume even at a plasma cholecystokinin concentration lower than observed postprandially. Another 8 subjects received the same infusions in combination with a background infusion of synthetic secretin (0.3 CU/kg X h). Gastric and duodenal juice was continuously aspirated using a double-marker perfusion technique. Neither of the gastrins caused an increase in the output of amylase, lipase, trypsin, chymotrypsin, or bilirubin, but both induced a modest increase in the output of bicarbonate and duodenal juice, the former only significantly during infusion of sulfated gastrin 17. The output of all parameters was significantly elevated during all doses of cholecystokinin-octapeptide. The results indicate that neither of the gastrins stimulates gallbladder contraction and pancreatic enzyme secretion in humans under physiologic conditions. However, gastrin may, like cholecystokinin, potentiate the effect of secretin on pancreatic secretion of juice and bicarbonate.

Concentrations of human pancreatic polypeptide (HPP) in serum were measured in the fasting state and after a meal in 19 control subjects and 24 patients with chronic pancreatitis (CP). The severity of CP was characterized on the basis of the duodenal lipase concentration after a test meal (Lundh test). Basal and postprandial HPP concentrations were significantly (p less than 0.01) decreased in severe and moderate chronic pancreatitis and in diabetes secondary to pancreatitis. There was only a weak correlation (r = 0.44; p less than 0.05) between exocrine secretion and delta HPP in CP. Fifty-eight percent of patients with CP had serum concentrations of HPP within the normal range, limiting the value of serum HPP measurement in the diagnosis of CP.

1. In accordance with the admixture theory of the exocrine pancreatic secretion a linear relation between concentrations of bicarbonate and protein in the pancreatic juice is to be expected.2. Pancreatic juice was obtained through a Thomas cannula in three unanaesthetized dogs during digestion of a meal.3. The actual concentration of bicarbonate and protein showed a good approximation to a straight-line relation.4. The calculated concentration of bicarbonate in the distal secretion was nearly identical with the highest concentration of bicarbonate obtained in the pancreatic juice after stimulation with secretin.