|Year : 1976 | Volume
| Issue : 2 | Page : 59-65
Effect of pentagastrin on blood sugar, serum amylase, lipase and calcium in normal, control and duodenal ulcer subjects
BD Pimparkar, PV Bodas, SM Dubhashi
Department of Nuclear Medicine, Medical Research Center of the Bombay Hospital Trust, Bombay-400029, India
B D Pimparkar
Department of Nuclear Medicine, Medical Research Center of the Bombay Hospital Trust, Bombay-400029
In order to gain an insight into the complex interactions and interdependancies between endocrine and exocrine glands, between incretory and excretory cells of the pancreas, and gut and endocrine hormones, we undertook to study the effects of subcutaneous pentagastrin on blood, sugar, serum amylase, lipase and calcium in 15 normal control and 50 radiologically proved duodenal ulcer subjects.
After subcutaneous pentagastrin, there was no change in one hour, in the values of serum calcium, amylase, lipase, and blood sugar, in both normal control and duodenal ulcer subjects. Since it did not produce any significant change in serum calcium levels, it seems that the stimulatory effects o f pentagastrin may not necessarily be due to changes in serum calcium levels.
|How to cite this article:|
Pimparkar B D, Bodas P V, Dubhashi S M. Effect of pentagastrin on blood sugar, serum amylase, lipase and calcium in normal, control and duodenal ulcer subjects.J Postgrad Med 1976;22:59-65
|How to cite this URL:|
Pimparkar B D, Bodas P V, Dubhashi S M. Effect of pentagastrin on blood sugar, serum amylase, lipase and calcium in normal, control and duodenal ulcer subjects. J Postgrad Med [serial online] 1976 [cited 2019 Aug 24 ];22:59-65
Available from: http://www.jpgmonline.com/text.asp?1976/22/2/59/42834
Intestinal hormones, like secretin, pancreozymin and cholecystokinin were supposed to affect only exocrine pancreatic function. The development of reliable, fast and precise methods for determining insulin, glucagon, secretin, pancreozymin and gastrin in blood by radioimmunoassay, has initiated major progress in clarifying the mechanisms operative in the control of pancreatic islet functions. In order to gain an insight into the complex interactions and inter-dependancies between endocrine and exocrine glands, between incretory and excretory cells of the pancreas, and gut, and endocrine hormones, we undertook to study the effects of subcutaneous pentagastrin on blood sugar, serum amylase, lipase and calcium.
Material and Methods
Fifteen normal control and fifty radio-, logically proved duodenal ulcer subjects were studied. Besides good clinical evaluation and radiological studies of the upper gastrointestinal tract, each subject also had had routine laboratory studies such as hemogram, stool, urine, X-ray chest and subcutaneous pentagastrin test.
After an overnight fast, and manual collection of fasting gastric contents, the gastric secretion was aspirated by continuous suction with a Stedman pump through the Ryle's tube which was placed in the most dependant part under fluoroscopic control. Basal secretion was collected for half an hour. Before, basal collection was started, blood was collected for estimation of fasting blood sugar, serum amylase, lipase and calcium. Flood sugar was estimated by the method of Folin and Wu,  Amylase by the methods of Somogy  and Nelson ,  Lipase by the method of Cherry and Crandall,  and Calcium by the method of Clark and Collip.  Gastric secretion was stimulated with 6 µg/ kg of pentagastrin given subcutaneously. The gastric secretion was collected in 15 minute aliquots for one hour. Each specimen was titrated against N/10 NaOH using Topfer's Reagent and Phenolphthalin as indicators for free and total acid. The results of this are being published separately. The blood sugar, serum amylase, lipase and calcium estimations were repeated half and one hour after stimulation with pentagastrin.
[Table 1] shows the mean ± S.E. values of blood sugar, serum amylase, lipase and calcium before and after stimulation with pentagastrin. There was no significant change after stimulation with pentagastrin.
Intestinal hormones were generally supposed to affect only the exocrine pancreatic function. The gut hormones, now, are considered to have double function of external digestion and internal metabolism, i.e., they affect absorption of food stuffs by the intestinal wall into lymphatics and peripheral blood circulation; and, also, on the uptake by the cells of various tissues and intracellular metabolism.
Gut hormones may be divided into two main groups-gastrin, pancreozymin and cholecystokinin, with common C-terminal tetra peptide amide which stimulate gastric acid-pepsin secretion; while secretin and glucagon (which are structurally related), inhibit the gastric secretion of acid and pepsin ,,,,,,,,,,,,,,,,,, . Pentagastrin produced little or no demonstrable pancreatic bicarbonate and protein response in man  . Antral extracts also have little or no effect on gall bladder or hepatic bile flow ,,.
A number of studies to estimate insulin response to different intestinal hormones have been carried out.  Secretin, pancreozymin, cholecystokinin, gastrin, glucagon, serotonin and some mucosal extracts did display, partially in synergism with glucose or aminoacids, insulin stimulatory capacities in normal animals and man ,,,,,, ,,, . However, insulin stimulatory action of each of these hormones seems to differ in man and rat, particularly in presence of exocrine pancreatic deficiency ,,, . Insulin response to stimulation by enteric hormones also seems to be dependent on blood glucose levels ,,,,,,,,, .
It is claimed that gastrin occurs within the islets of Langerhans, , and extract of pancreatic α1 cells of pigeons were shown to inhibit insulin secretion.  From this it has been postulated that α1 cells and endogenous gastrin are concerned in the regulation of insulin release by local mechanism. It is further postulated that blood glucose is regulated by local mutual interaction between α1 - α2 - β cells.  However, to accept this, convincing evidence for the release of gastrin from a cells is awaited. Till then, G.I. hormones, secretin and pancreozymin have been considered by Pfiffer et al,  as modulating discriminators between α1 -βcells.
Since estimation of secretin, cholecystokinin, gastrin, glucagon and insulin, by radio-immunoassay was not possible in our place when we undertook these studies, we had to rely on indirect evidence in the form of serum amylase, lipase, calcium and blood sugar.
Pentagastrin, in humans, in a short period of one hour does not cause any change in either blood sugar, serum amylase, lipase and calcium. Whether it will do so by prolonged, continuous or repeated stimulations, remains to be seen. Since it did not produce any change in serum calcium levels, it seems that the stimulatory effect of pentagastrin is not necessarily due to changes in serum calcium levels. More likely, it may be due to either direct action on parietal and chief cells or through vagus or through intracellular release of histmaine as postulated by Kahlson,  et al.
This project was supported by a Research Grant from the Indian Council of Medical Research. We acknowledge generous supply of Pentagastrin by the I.C.I. Ltd., (U.K.). The authors are grateful to Dr. J. S. Mishra and the Superintendent, Medical Research Center of Bombay Hospital Trust for giving all the facilities to carry out the research. Thanks are also due to Mrs. K. D. Lotlikar for statistical analysis.
|1||Aguilar Parada, E., Eisentraut, A, M., and Unger, R. H.: Pancreatic Glucagon Secretion in Normal and Diabetic Subjects. Amer. J. Med. Sci. 257: 415-4166, 1869.|
|2||Blair, E. L., Clark, D. G., Harper, A. A., Lake, H. J., and Scratcherd, T.: A Gastric Phase of Pancreatic Secretion in Cats. J. Physiol. (Lond.), 157: 17p-18p, 1931.|
|3||Blair, F. L., Falkner, S . , Hellerstroms, C., Ostberg, H., and Richardson, D.: Investigations of Gastrin Activity in Pancreatic Islet Tissue. Acta Pathol. Microbiol. Scand., 75: 583-597, 1969. Quoted by Jorpes & Mutt, 1973.|
|4||Boyns, D. R., Jarrett, R. J. and Keen, H.: Intestinal Hormones and Plasma Insulin. Lancet, II: 409-410, 1985.|
|5||Boyns, D. R., Jarrett, R. J. and Keen, H.: Intestinal Hormones and Plasma Insulin. An Insulinotropic Action of Secretin. Brit. Med. J., II: 676-678, 1967.|
|6||Buchanan, K. D . , Vance, J. E . , and William, R. H.: Insulin and Glucagon Release from Isolated Islets of Langerhans, Effect of Enteric Factors. Diabetes, IF: 381386, 1909.|
|7||Buchanan, K. D., Vance, J. E., Aol, T., and William, R. H.: Rise in Serum Immunoreactive Glucagon after intrajejunal Glucose in Pancreaticomised Dogs. Proc. Sec. Exp. Biol. (N.S.), 125: 813815, 1967.|
|8||Buchanan, K. D., Vance, J. E., Morgan, A., and William, R. H.: Effect of Pancreozymin on Insulin and Glucagon Levels in Blood and Bile. Amer. J. Physiol., 6. 1293-1298, 1968.|
|9||Buchanan, K. D., Vance, J. E., Aoki, T., Dinstl, K. and William, R. H.: Effect Blood Glucose on Glucagon Secretion in Anaesthesized Dogs. Diabetes, 18: 627-632, 1969.|
|10||Cherry and Crandall. L. A., Jr.: The specificity of Pancreatic Lipase: Its appearance in the Blood after Pancreatic Injury. Amer. J. Physiol. 113: 268-273, 1932.|
|11||Clark, E. P. and Collip, J. B.: A Study of the Tisdall Method for the Determination of Blood Serum Calcium with a Suggested Modification. J. Biol. Chem. 63: 461-464, 1925.|
|12||Cumming, J. D.. and Percival, H. G.: The effect of Glucagon upon Gastric Secretion and Total Stomach Blood Flow, J. Physiol, (London), 191: 81-82, 1967.|
|13||Curtis, J. D., Dupre, J. and Beck., J. C.: Effects of Secretin, Pancreozymin and Gastrin on Insulin Release in-vitro. Clin. Res., 16: 521-527, 1988.|
|14||Dotevall, G. and Walan, A: Inhibition of Pentagastrin Induced Gastric Acid Secretion of Man by Glucagon Given IntraIntravenously. Scan. J. Gastroenterology, 4: 713-716., 1939.|
|15||Dotevall, G., Gillberg, R., Kock, N. G. and Walan, A.: Stimulatory and inhibitory Effects of Gastric Secretion in Man by Glucagon. Infusion in Small Doses. In Abstracts of 4th World Congress of Gastrcenterology, p. 133, Copenhagan, 19H.|
|16||Dotevail, G., Gillberg, R., Kock, N. G and Walan, A.: Gastric Secretion of Acid and Pepsin in Man During Glucagon Infusion in Small Doses, Gastroenterology, 58: 942, 1970.|
|17||Dreilting, D. A. and Janowitz, H. D.: The Effects of Glucagon on Gastric Secretion in Man. Gastroenterology, 36: 580581, 1959.|
|18||Emas, S., Billings, A. and Grossman, M. I.: Effects of Gastrin and Pentagastrin on Gastric and Penacreatic Secretion in Dogs, Scand. J. Gastroenterology, 4: 609-616, 1969.|
|19||Folin, O. and Wu, H.: System of blood analysis: A Simplified and Improved Method for Determination of Sugar. J. Biol. Chem. 41: 367, 1920.|
|20||Fussganger, R. D., Straub, K., Goberno, R., Jaros, P., Schroder, K. E., Raptis, S. and Pfeiffer, E. F.: Primary Secretion of Insulin and Secondary Release of Glucagon from the Isolated Perfused Rat Pancreas following Stimulation with Pancreozymine. Horm., Met. Res. Suppl. 1: 224-227, 1939. Quoted by Pfeiffer et al, 1973.|
|21||Fussganger, R. D., Goberna, R., Schroder. K. E., Laube, H. and Pfeiffer, E. F.: Abnormally High Glucagon Secretion of the Streptozotocin Diabetic, Isolated, Perfused Rat Pancreas. Evidence for a lack of Suppression due to the Deprivation of Endogenous Insulin Release. 7th Annual Meeting of the European Society for the Study of Diabetes, Southampton, 1971, Abstract, 67. Quoted by Pfeiffer et al,} 1973.|
|22||Fussganger, R. D., Goberna, R., Laube, H., Schroder, K. E., Raptis, S. and Pfeiffer, E. F.: Glucagon Secretion from the Isolated Perfused Rat Pancreas, Influenced by Glucose, Tolbutamide and Pancreozymine Mediated Release of Pancreatic Insulin. Israel J. Med. Sci. 8: 2-3, 1972. Quoted by Pfeiffer et al, 1973.|
|23||Goberna, R., Fussganger, R. D., Raptis, S., Telib, M. and Pfciffer, E. F.: The Role of the Exocrine Pancreas in the Stimulation of Insulin Secretion by Intestinal Hormones, II Insulin Responses to Secretin and Pancreozymin in Experimental Insufficiency of the Exocrine Pancreas.Diabetologia, 7: 65-72, 1971. Quoted by Pfeiffer et al, 1973.|
|24||Goberna, R., Raptis, S., Fussganger, R. D. and Pfeiffer, E.: Effect of Secretin and Pancreozymin on Insulin Secretions in Exocrine Pancreatic Insufficiency in Rat. 5th Annual Meeting, Europ. Assoc. for the Study of Diabetes, Montpellier, 1969, Diabetologia (Abstr.) 6: 4S, 1970. Quoted by Pfeiffer et al, 1973.|
|25||Greenlee, H. B., Longhi, E. H., Guerrero, J. D., Nelson, T. S., El-Nedri, A. L. and Dragstedt, L. R.: Inhibitory Effect of Pancreatic Secretin on Gastric Secretion. Amer. J. Physiol., 198: 396-402, 1957.|
|26||Gregory, R. A. and Tracy, H. J.: The Constitution and Properties of two Gastrins Extracted from Hog Antral Mucosa. Gut, 5: 103-117, 1964.|
|27||Handwerger, S., Roth, J., Gorder, P., Saint Agnese, P. D., Carpenter D. F. and Peter, G.: Glucose Intolerance in Cystic Fibrosis, New Engl. J. Med. 281: 451-431, 1969.|
|28||Hellman, B. and Lernmark, A.: Inhibition of the in Vitro Secretion of Insulin by an Extract of the Pancreatic a, Cells. Endocrinology, 84: 1484-1488, 1969.|
|29||Iversen, J.: Secretion of Glucagon from the Isolated Perfused Canine Pancreas. J. Clin. Invest., 50: 2123-2136, 1971.|
|30||Jones, R, S. and Grossman, M. I,: Cholleretic Effects of Cholecystokinin, Gastrin II and Caerulein in Dog. Amer. J, Physiol., 219: 1014-1018, 1970.|
|31||Jorpes, J. E. and Mutt, V.: Secretin, Cholecystokinin (CCK), In, "Secretin Cholecystokinin, Pancreozymin and Gastrin. Springer Verlag, Berlin, 1973.|
|32||Kahlson, G., Rosengren, E.. Savahn, D, and Thunberg, R.: Mobilization and Formation of Histamine in Gastric Mucosa as related to Acid Secretion. J. Physiol., (London), 174: 400-416, 1964.|
|33||Kaneto, A., Tasaka, Y. Kosaka, K, and Nakao, K.: Stimulation of Insulin Secretion by the C-terminal Tetrapeptide amide of Gastrin. Endocrinology, 84: 1098-1106, 1969.|
|34||Lomsky, R., Langer, F. and Vortel, V.: Immunohistochemical Demonstration of Gastrin in Manmalian Islets of Langerhans, Nature, (London), 223: 618-619, 1939.|
|35||Magee, D. F. and Nakamura, M.: Action of Pancreozymine Preparations on Gastric Secretion. Nature, 212: 1487-1488, 1970.|
|36||Muller, W. A., Faloona, G. R., Aguilar Parada, E. and Unger, R. H.: Abnormal Alpha-Cell Function in Diabetes, Response to Carbohydrate and Protein Ingestion. New Engl. J. Med., 283: 109-115, 1970.|
|37||Muller, W. A., Faloona, C. R. and Unger, R. H.: The Effect of Experimental Insulin Deficiency on Glucagon Secretion. J. Clin Invest., 50: 1992-1999, 1971.|
|38||Muller, W. A., Faloona, G. R. and Unger, R. H.: The Effect of Alanine on Glucagon Secretion, J. Clin. Invest. 50: 221-225, 1971.|
|39||Murat, J. F. and White, T. T.: Simulation of Gastric Secretion by Commercial Cholecystokinin Extracts. Proc. Soc. Exper. Biol. (N.Y.), 123: 593-584, 1966.|
|40||Nelson, N.: A Photometric Adaptation of the Somogyi Method for the determination of Glucose. J. Biol. Chem. 153: 375-380, 1944.|
|41||Ohagwara, H., Mizuno, Y., Tasaka, Y. and Kosaka, K.: Effect of C-terminal Tetrapeplide amid of Gastrin on Insulin Secretion in Man. J. Clin. Endocr., 29: 1261-1.232, 1969.|
|42||Passaro, E. J. and Grossman, M. I.: Studies of the Gastric Phase of Pancreatic Secretion. Gastroenterology, 44: 864-865, 1933.|
|43||Petersen, H.: The Effect of Secretin on Basal Gastric Acid Secretion in Man. Scan. J. Gastroenterology, 4: 609-316, 1969.|
|44||Petersen, H. Berstad, A. and Myren, J.: Effect of Secretin on Histamine and Pentagastrin Stimulated Secretion of Acid in Man. In Abstract. 4th World Congress of Gastroenterology. p. 137: Copenhagan, 1970.|
|45||Pfeiffer, E. F., Raptis, S. and Fussganger, R.: Gastrointestinal Hormones and Islet Function. p. 259-310, in Secretin, Cholecystokinin, Pancreozymin and Gastrin, Springer-Verlag, Berlin, 1973, Edited by Jorpes, J. E. and Mutt, V.|
|46||Pimparkar, B. D., Bodas, P. V. and Dubhashi, S. M.: Optimum Dose of Peptavlon for Maximal Gastric Acid Secretion in Indians. In Press.|
|47||Pimparkar, B. D., Dubhashi, S. M. ana Bodas, P. V.: Optimum Dose of Peptavlon for Maximal Gastric Pepsin Secretion in Indians. In Press.|
|48||Preshaw, R. M., Cooke, A. R, and Grossman, M. I.: Stimulation of Pancreatic Secretion by a Humoral Agent from the Pyloric Gland Area of the Stomach. Gastroenterology, 49: 617-622, 1955.|
|49||Preshaw, R. M. Cooke, A. R. and Grossman, M. I.: Pancreatic Secretion Induced by Stimulation of the Pyloric Gland Area of the Stomach. Science. 148: 1347-1348, 1965.|
|50||Raptis, S., Rau, R. N., Schroder, K. E., Hartmann, W., Faulhaber, J. D., Clodi, P. H. and Pfeiffer, E. F.: The role of the Exocrine Pancreas in the Stimulation of Insulin Secretion and Pancreozymin and to oral and intravenous Glucose in Patients suffering from chronic insufficiency of the Pancreas. Diahatologia, 7: 16C-167, 1971, Quoted by Pfeiffer et al 1973.|
|51||Raptis, S., Faulhaber, J. D. and Schroder, K. E.: The Effect of Intestinal Hormones upon Lipolysis of Isolated Human Fat: Cells. Horm. Met. Res. Suppl. 249-250, 1969, Quoted by Pfeiffer et al 1973.|
|52||Raptis, S., Rau, R. M., Schroder, K. E., Hartmann, W., Faulhaber, H. D., Clodi, P. H. and Pfeffler, E. F.: The Role of Exocrine Pancreas in the Stimulation of Insulin Secretion by Intestinal Hormones. III Insulin Responses to Secretin and Pancreozymin and to Oral and Intravenous Glucose, in Patient Suffering from Chronic Insufficiency of the Exocrine Pancreas Diabetologia 7: 160-167, 1971, Quoted by Pfeiffer et al 1973.|
|53||Rehfeld, J. F.: Effect of Gastrin and its terminal. Tetrapeptide on Insulin Secretio1 in Man. Acta Endocrinologia, 66: 169-175, 1971.|
|54||Robinson, R. A., Harris, K., Hlad, C. J and Eiseman, B.: Effect of Glucagon on Gastric Secretion. Proc. Soc. Exper Biol. (N.Y.), 96: 518-520, 1957.|
|55||Schroder, K. E., Raptis, S. Telib, M. and Pfeiffer, E. F.: Intestinal Hormones Affecting Insulin Secretion in Vitro, Secretin, Pancreozymin, Gastrin, 6 th Congress International Diabetes Federation, In, E. F., Pfeiffer's Intestinal Factors Controlling Insulin Secretion, 6th Congress I.D.F., Stockholm, 1967, Exc. Med. Foundation, I.C.S., 172, 1969 p. 419-424. Quoted by Pfeiffer et al, 1973.|
|56||Soloman, S. P. and Spiro, H. M.: The Effect of Glucagon and Glucose on the Human Stomach, Amer. J. Digest. Dis.,(N. S.) 4: 775-786, 1959.|
|57||Somogyi, M.: Micromethods for the Estimation of Diastase. J. Biol. Chem. 125: 399-414, 1.638.|
|58||Somogyi, M.: A New Reagent for the Determination of Sugar. J. Biol. Chem160: 61-68, 1945.|
|59||Somogyi, M.: Notes on Sugar Determination. J. Biol. Chem. 195: 19-23, 1952.|
|60||Tracy, H. J. and Greogy, R. R..Physiological Properties of a Series of Synthetic Peptides Structurally Related to Gastrin. I. Nature, 204: 935-938, 1934.|
|61||Unger, R. H., Augilar Parada, E., Muller,W. A. and Essen-Traut, A. M.: Studies of Pancreatic Alpha-Cell Function in Normal and Diabetic Subjects. J. Clin.Invest. 49: 837-848, 1970.|
|62||Vagne, M. and Grossman, M. I.: Cholecystokinetic Potency of Gastrointestinal Hormones and Related Peptides. Amer. J. Physiol. 215: 881-884, 1968.|
|63||Venables, C. W., Rudick, J., Kark, A., and Dreilling, D, A.: Effect of Commercial Pancreozymin Preparation, (Cecekin) and Gastrin Pentapeptide upon Acid and Pepsin Secretion in Gastric Fistula Dogs, J.Surg. Research 9: 55-60, 1969, Quoted by Jorpes and Mutt (1973).|
|64||Von Hallenbeck, G. A. and Haimburg, R. L.: Inhibition of Gastric Secretion in Dogs by Glucagon given Intraportally. Gastroenterology, 47: 531-535, 1964.|
|65||Wormsley, K. G., Mahoney, M. P. and Margaret, N. G.: Effect of Gastrin like Pentapeptide, (I.C.I. 50123) on Stomach and Pancreas Lanset, I: 993-996, 1966.|
|66||Young, J. D., Lazarus, L., Chisholm, D. J, and Atkinson, F. F. V.: Radioimmunoassay of Secretin in Human Serum. J. Nucl. Med. 9: 641-642, 1968.|
|67||Young, J. D., Lazarus, L., Chisolm, D. J. and Atkinson, F. F. V., Radioimmunoassay of Pancreozymin Cholecystokinin in Human Serum. J. Nucl. Med., 10: 743745, 1969.|
|68||Young, J. D., Lazarus, L. and Chisolm, D, J.: Secretin and Pancreozymin cholecystokinin after Glucose. Lacet. II: 914, 1968.|