Effect of pentagastrin on blood sugar, serum amylase, lipase and calcium in normal, control and duodenal ulcer subjects

Correspondence Address:
B D Pimparkar
Department of Nuclear Medicine, Medical Research Center of the Bombay Hospital Trust, Bombay-400029
India

Source of Support: None, Conflict of Interest: None

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PMID: 1032678

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.

:: Introduction

:: Material and Methods

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, ^[19] Amylase by the methods of Somogy ^[57] and Nelson , ^[40] Lipase by the method of Cherry and Crandall, ^[10] and Calcium by the method of Clark and Col­lip. ^[11] 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.

:: Results

[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.

:: Discussion

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 ^{[1],[12],[14],[18],[25],[26],[31],[35],[39],[42],[43],[44],[46],[47],[48],[56],[60],[63],[64]} . Pentagastrin pro­duced little or no demonstrable pancreatic bicarbonate and protein response in man ^[65] . Antral extracts also have little or no effect on gall bladder or hepatic bile flow ^{[30],[60],[62]}.

A number of studies to estimate insulin response to different intestinal hormones have been carried out. ^[45] 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 ^{[13],[29],[33],[41],[45],[53], [55],[61],[66],[67]} . However, in­sulin stimulatory action of each of these hormones seems to differ in man and rat, particularly in presence of exocrine pancreatic deficiency ^{[24],[27],[45],[52]} . Insulin response to stimulation by enteric hor­mones also seems to be dependent on blood glucose levels ^{[1],[6],[21],[22],[23],[37],[45],[52],[61],[68]} .

It is claimed that gastrin occurs within the  Islets of Langerhans ^{More Details}, ^[2],[34] and extract of pancreatic α₁ cells of pigeons were shown to inhibit insulin secretion. ^[28] 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. ^[45] 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, ^[45] 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, ^[32] et al.

:: Acknowledgement

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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Tables

  [Table 1]

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