Effect of urogastrone on gastric secretion and serum gastrin concentration in patients with duodenal ulceration.

Abstract

SUMMARY A one-hour infusion of 0.25 ,ug/kg urogastrone administered to seven patients with duodenal ulceration resulted in significant reduction of basal acid secretion (p<005) but was without significant effect on basal pepsin and intrinsic factor secretion or on serum gastrin concentration. In another group of five patients with duodenal ulceration a one-hour infusion of urogastrone was given on five successive days. On day 1 and 5 urogastrone was administered after establishing a plateau response to intravenous pentagastrin 1.2 ,ug/kg/h. A mean reduction of 65% in acid output during the urogastrone infusion was seen on day 1 and this was maintained during the next hour. On day 5 the pentagastrin-stimulated acid output was less than on day 1 and a further significant decrease was noted after urogastrone. Pepsin and intrinsic factor output were also significantly inhibited. There was no change in fasting serum gastrin or urogastrone concentration.Urogastrone has recently been extracted from human material and, although two pure polypeptides were obtained, these were shown to be the same, apart from one additional amino acid.' Studies in humans have been carried out using mixture of the 52 and 53 amino acid residue peptides which have the same biological actions. Studies in normal volunteers2 showed that urogastrone (0.25 1Lg/kg/h intravenously) inhibited secretagoguestimulated acid secretion with no effect on serum gastrin concentration. In patients with ZollingerEllison syndrome3 there was marked inhibition of acid secretion and a rise in serum gastrin concentration. In addition, patients with ZollingerEllison syndrome experienced pain relief during the urogastrone infusion and for up to 24 hours afterwards.As urogastrone has been found to be virtually free from unwanted side-effects in these human studies and in extensive animal trials over many years, it is possible that it may have a role in the treatment of peptic ulceration. It was therefore considered important to evaluate its effect on gastric secretion ' Address for correspondence: C. G. Koffman, Leighton Hospital, Middlewich Road, Crewe CWI 40J. Received for publication 26 February 1982 and serum gastrin concentration in patients with active duodenal ulceration both in the basal and pentagastrin-stimulated state. We have also investigated the possibility of a cumulative effect of repeated urogastrone infusions. Methods PATIENTSTwelve male patients with chronic duodenal ulcer took part in this study and informed consent was obtained in each case. The diagnosis was confirmed in each patient both by barium meal and duodenoscopy which was always performed within seven days of the start of the study. Only patients with no history of physical signs of disease of any other major system were included, and no patient had previously undergone gastric surgery. In addition, no patients received H2-receptor antagonists within two weeks of the study. Another five patients with duodenal ulceration underwent pentagastrin infusion over a three-hour period in order ...

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