Effect of Secretin on Circulating Gastrin

Thompson, James C.; Reeder, David D.; Bunchman, Herbert H.; Becker, H. D.; Brandt, Edward N.

doi:10.1097/00000658-197209000-00014

Cited by 167 publications

(28 citation statements)

References 31 publications

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“…DU patients, on the other hand, failed to exhibit such a response to the secretin challenge. In fact, these patients responded to secretin with a progressive decrease in serum gastrin in keeping with previous observations (8,14,24).…”

Section: Discussionsupporting

confidence: 92%

Calcium and Secretin as Provocative Stimuli in the Zollinger-Ellison Syndrome

Mihas¹,

Hirschowitz²,

Gibson³

1978

Digestion

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The effects of calcium and secretin were studied in 8 patients with the Zollinger-Ellison syndrome and 18 patients with duodenal ulcer disease. Intravenous infusion of calcium gluconate produced marked increases in serum gastrin levels in the patients with Zollinger-Ellison syndrome (4,350 ± 1,625 pg/ml) and very slight increases in the patients with duodenal ulcer disease (140 ± 49 pg/ml). Secretin given as a single intravenous injection also induced marked elevations in serum gastrin in the group with the Zollinger-Ellison syndrome (4,063 ± 1,990 pg/ml). By contrast, intravenous secretin resulted in a progressive fall in serum gastrin levels in the duodenal ulcer group (from 119 to 97 pg/ml). These results suggest that both stimuli are very useful dagnostic tools in discriminating between Zollinger-Ellison and non-Zollinger-Ellison patients. The secretin challenge test is felt to be superior to the calcium infusions because it is simpler, safer and very rarely produces false-negative or -positive results.

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Section: Discussionsupporting

confidence: 92%

Calcium and Secretin as Provocative Stimuli in the Zollinger-Ellison Syndrome

Mihas¹,

Hirschowitz²,

Gibson³

1978

Digestion

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“…The reason for the marked increase in serum gastrin after a test meal in some ZE patients is not clear. Several mechanisms may be put forward to account for the pronounced meal stimulated increase in serum gastrin in these patients, as direct interaction between food and a tumour originated in the duodenal wall, the release of a gastrin stimulating agent-for example, secretin-from the small intestine and co-existing antral G-cell hyperplasia and pancreatic tumours (Polak et al, 1972 (Korman et al, 1973b;Lamers et al, 1977), excluded gastric antrum (Korman et al, 1972b), non-tumorous hypergastrinaemic hyperchlorhydria (Straus and Yalow, 1975), and postprandial conditions (Thompson et al, 1972b). In patients with achlorhydria and excluded gastric antrum, marked increases in serum gastrin after calcium infusion have been found (Straus and Yalow, 1975;Lamers and van Tongeren 1976).…”

Section: Resultsmentioning

confidence: 99%

“…The value of these tests has been studied in small series (Berson and Yalow, 1972;Isenberg et al, 1972;Thompson et al, 1972b;Becker et al, 1973;Bradley et al, 1973;Korman et al, 1973a, b;Bonfils et al, 1974) and, recently, in relatively larger groups of ZE patients (Creutzfeldt et al, 1975;Thompson et al, 1975). However, comparison of the value of different provocation tests in the same patient has not been recorded previously.…”

mentioning

confidence: 99%

Comparative study of the value of the calcium, secretin, and meal stimulated increase in serum gastrin to the diagnosis of the Zollinger-Ellison syndrome.

Lamers¹,

Tongeren²

1977

Gut

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SUMMARY To evaluate the usefulness of provocation tests in the diagnosis of the Zollinger-Ellison (ZE) syndrome stimulation tests with calcium, 15 mg/kg.3 h, and secretin GIH, 1 U/kg.30 s, were performed in 15 patients with histologically proven or suspected ZE syndrome. Nine of these 15 patients were without previous gastric surgery and in them meal stimulated serum gastrin levels were measured as well. These tests were also performed in normal subjects and in patients with duodenal ulcer, antrectomy, total gastrectomy, and achlorhydria. All tests were considered to be positive if a more than a 50 % increase in serum gastrin was found. The results indicate that secretin stimulation is the provocation test of first choice in the diagnosis of this syndrome. This test is most valuable for the following reasons: (1) there were few (two out of 15) false-negative test results in ZE patients; (2) there were no false-positive tests in 69 patients without gastrinoma; (3) it was easy and quick to perform; and (4) there were no adverse reactions. The two ZE patientswithnegativesecretinstimulation tests had negative calcium provocation tests as well, in spite of histologically proven gastrinoma. In 11 patients with suspected or proven ZE syndrome and basal serum gastrin levels of less than 1000 pg/ml a rather good correlation (r = 0-841; p < 0 01) was found between the percental increase in serum gastrin after stimulation by calcium and secretin. Meal stimulated serum gastrin levels are helpful only in patients without previous gastric surgery.

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“…Statistical differences (p < 0.05) were determined by the Stu dent's t test for paired data. Integrated values were cal culated as described previously [8].…”

Section: Statisticsmentioning

confidence: 99%

Neurotensin Secretion in Response to Intraduodenal and Intraileal Administration of Fat in Dogs

et al. 1992

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Release of neurotensin from the small intestine in response to administration of fat directly into the duodenum and ileum was examined in conscious dogs. The present results show that: (1) intraduodenal administration of fat causes a biphasic release of neurotensin which is mediated, at least in part, by cholinergic mechanisms, and (2) both a fatty acid (sodium oleate) and a triglyceride, when infused directly into an isolated ileal loop, stimulate a significant release of neurotensin. Our findings indicate that release of neurotensin is triggered by mechanisms originating in the proximal small intestine and by a direct contact of nutrients with the ileal mucosa.

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Effect of Secretin on Circulating Gastrin

Cited by 167 publications

References 31 publications

Calcium and Secretin as Provocative Stimuli in the Zollinger-Ellison Syndrome

Calcium and Secretin as Provocative Stimuli in the Zollinger-Ellison Syndrome

Comparative study of the value of the calcium, secretin, and meal stimulated increase in serum gastrin to the diagnosis of the Zollinger-Ellison syndrome.

Neurotensin Secretion in Response to Intraduodenal and Intraileal Administration of Fat in Dogs

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