|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.
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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
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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 2020 Jan 25 ];22:59-65
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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.
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