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Pancreatic secretion after secretin and cholecystokinin stimulation in chronic alcoholics with and without cirrhosis

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Abstract

We have studied the volume, protein concentration, total protein, and chymotrypsin and trypsin outputs in pure pancreatic juice (PPJ) following endoscopic cannulation of the pancreatic duct in 11 male and 2 female patients with advanced alcoholic cirrhosis (AC). Results were compared to those obtained from 21 nonalcoholic volunteers (NAV) and 26 chronic alcoholic (CA) patients without cirrhosis. Intravenous stimulation with secretin followed 10 min later by intravenous cholecystokinin-pancreozymin (CCK-PZ) resulted in highly significant increases in volumes during both phases of pancreatic stimulation in AC compared to NAV and CA. Protein concentration and total output during secretin stimulation was not different among the three groups. During CCK-PZ stimulation, CA exhibited a significant elevation in protein concentration and total output compared to NAV and AC. Although total chymotrypsin output was lower in secretin-stimulated CA than other groups, no other differences between the groups were observed in either of the hormone-stimulation phases. Marked elevations in trypsin output were observed in secretin-stimulated AC and in CCK-PZ-stimulated AC and CA. The high PPJ volume and the relatively low protein concentration observed in AC may effect a washout phenomenon resulting in a decreased tendency for ductal protein precipitation in these patients.

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References

  1. Renner IG, Rinderknecht H, Valenzuela JE, Douglas AP: Studies of pure pancreatic secretions in chronic alcoholic subjects without pancreatic insufficiency. Scand J Gastroenterol 15:241–144, 1980

    Google Scholar 

  2. Renner IG, Rinderknecht H, Stace NH: Pure pancreatic secretions in male and female chronic alcoholic patients without pancreatic insufficiency. Gastroenterology 80(5):1261, 1981

    Google Scholar 

  3. Rinderknecht H, Renner IG, Douglas AP, Adham NF: Profiles of pure pancreatic secretions obtained by direct pancreatic duct cannulation in normal healthy human subjects. Gastroenterology 75:1083–1089, 1978

    Google Scholar 

  4. Dreiling DA, Greenstein AJ, Bordalo O: The hypersecretory states of the pancreas. Am J Gastroenterol 59:505–511, 1973

    Google Scholar 

  5. Van Goidsenhoven GE, Henke WJ, Vacca JB, Knight WA: Pancreatic function in cirrhosis of the liver. Am J Dig Dis 8:160–173, 1963

    Google Scholar 

  6. Adler HL, Roessler EB: Introduction to Probability and Statistics. San Francisco, WH Freeman, 1968, pp 136–148

    Google Scholar 

  7. Steele RGD, Torie JH: Principles and Procedures of Statistics. New York, McGraw-Hill, 1960, pp 99–131

    Google Scholar 

  8. Worning HS, Mullertz S, Thaysen EH, et al: pH and concentration of pancreatic enzymes in aspirates from the human duodenum during digestion of a standard meal in patients with biliary or hepatic disorders. Scand J Gastroenterol 2:150–156, 1967

    Google Scholar 

  9. Moeller DD, Dunn GD, Klotz AP: Pancreatic function in malabsorbing alcoholic cirrhotics. Am J Dig Dis 19(9):779–784 1974

    Google Scholar 

  10. Friedman AI, Cheng LK: Pancreatic function in portal cirrhosis. Am J Gastroenterol 35:492–498, 1961

    Google Scholar 

  11. Rinderknecht H, Renner IG, Koyama HH: Lysozomal enzymes in pure pancreatic juice from healthy volunteers and chronic alcoholics. Dig Dis Sci 24(3):180–186, 1979

    Google Scholar 

  12. Renner IG, Rinderknecht H, Douglas AP: Profiles of pure pancreatic juice secretions in patients with acute pancreatis: The possible role for proteolytic enzymes in pathogenesis. Gastroenterology 75:1090–1098, 1978

    Google Scholar 

  13. Rinderknecht H, Renner IG, Stace NH: Abnormalities in pancreatic secretory profiles of patients with cancer of the pancreas. Dig Dis Sci 28(2):103–110, 1983

    Google Scholar 

  14. Renner IG, Pantoja JL, Peters R: Frequency of pancreatitis in alcoholic liver disease. Clin Res 27:28A, 1979

    Google Scholar 

  15. Dagorn JC, Lahaie RG: Dietary regulation of pancreatic protein synthesis. I. Rapid and specific modulation of enzyme synthesis by changes in dietary composition. Biochim Biophys Acta 654:111–118, 1981

    Google Scholar 

  16. Dagorn JC, Paradis D, Morisset J: Non-parallel response of amylase and chymotrypsinogen biosynthesis following pancreatic stimulation: A possible explanation for observed nonparallelism in pancreatic secretion. Digestion 15:110–120, 1977

    Google Scholar 

  17. Scheele GA: Biosynthesis, segregation, and secretion of exportable proteins by the exocrine pancreas. Am J Physiol 238:G467-G477, 1980

    Google Scholar 

  18. Bourdel G: Effect of separate feeding of protein and lipids on pancreatic adaptation in the rat. Am J Physiol 224(2):G125-G130, 1983

    Google Scholar 

  19. Rothman SS: “Non-parallel transport” of enzyme protein by the pancreas. Nature 213:460–462, 1967

    Google Scholar 

  20. Rothman SS, Isenman LD: Secretion of digestive enzyme derived from two parallel intracellular pools. Am J Physiol 226(5):1082–1087, 1974

    Google Scholar 

  21. Lee SP, Lai KS: Exocrine pancreatic function in hepatic cirrhosis. Am J Gastroenterol 65(3):244–248, 1976

    Google Scholar 

  22. Skillman JJ, Silen W, Harper HA: Role of the liver in secretin inactivation. Am J Physiol 202:347–348, 1962

    Google Scholar 

  23. Chey WY, Hendricks J, Lorber SH: Inactivation of secretin by the liver. Clin Res 19:389, 1971

    Google Scholar 

  24. Justus PG, Wheeldon SG, Kolts BE: Secretin half-life in cirrhotics with high secretory volumes to a secretin test. Proc Soc Exp Biol Med 162:351–353, 1979

    Google Scholar 

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Renner, I.G., Rinderknecht, H. & Wisner, J.R. Pancreatic secretion after secretin and cholecystokinin stimulation in chronic alcoholics with and without cirrhosis. Digest Dis Sci 28, 1089–1093 (1983). https://doi.org/10.1007/BF01295807

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  • DOI: https://doi.org/10.1007/BF01295807

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