Heterogeneity of Plasma Motilin in Patients with Chronic Renal Failure

Abstract

Plasma immunoreactive motilin (IRM) concentrations were strikingly higher in patients with chronic renal failure (CRF) than in normal subjects. IRM in azotemic plasma was heterogeneous in gel-filtration profile. The first peak eluted in the void volume of the column and the second and the third one, comprising a major portion of IRM content, came out coincidentally with insulin and authentic motilin, respectively. By contrast, no discernible amount of IRM was found in the region corresponding with the second peak in gel-filtration of the plasma from normals and very little in a patient with ileus whole plasma IRM level was elevated. The hypermotilinemia and the accumulation of this high molecular weight motilin in patients with CRF suggest that the kidney plays some role in the elimination of motilin, and further, that the clearance of the high molecular motilin is more dependent on renal function than that of authentic motilin. The present paper emphasizes the necessity for clarifying the significance of the heterogeneity of IRM in CRF.

Nonsteroidal anti‐inflammatory drugs induce hypermotilinemia and disturbance of interdigestive migrating contractions in instrumented dogs

“…There are a few reports that diabetes (Nakanome et al. , 1983) or chronic renal failure (Shima et al. , 1980) can cause hypermotilinemia via a secretion or elimination abnormality; however, these disorders were not observed in any dogs in our study.…”

“…Hypermotilinemia is thought to be the result of either hyperproduction, hypersecretion, abnormal metabolism or abnormal elimination. There are a few reports that diabetes (Nakanome et al, 1983) or chronic renal failure (Shima et al, 1980) can cause hypermotilinemia via a secretion or elimination abnormality; however, these disorders were not observed in any dogs in our study. Some gastrointestinal hormone levels are higher in liver cirrhosis (Usami et al, 1998), possibly because of abnormal metabolism, but, in the present study, liver abnormalities were not observed.…”

“…Although the reason for hypermotilinemia is still unclear, it may be that it is associated with a significant change in motilin cell distribution in the duodenum and jejunum. Some reports have also shown that hypermotilinemia is found in several gastrointestinal motility disorders (Shima et al, 1980;Nakanome et al, 1983). Thus, we speculate that disturbance of IMCs, observed in the present study, is associated with hypermotilinemia but not with gastric ulcers directly.…”

“…Although the reason for hypermotilinemia is still unclear, it may be that it is associated with a significant change in motilin cell distribution in the duodenum and jejunum. Some reports have also shown that hypermotilinemia is found in several gastrointestinal motility disorders (Shima et al. , 1980; Nakanome et al.…”

An Unusual Metastatic Motilin-Secreting Neuroendocrine Tumour with a 20-Year Survival

“…Using gel chromatography Christofides et al [19]observed two peaks of immunoreactive motilin in human plasma, one corresponding to the 22-amino acid peptide, the other one being a larger molecular form probably extended at the C-terminal end. In patients with hypermotilinemia, especially in patients with renal insufficiency, the large molecular form is increased [20, 21], and this was interpreted as due to a disturbance of the metabolism of motilin. In our patient, however, the chromatographic profile was identical when a C- or N-terminal antibody was used, which suggests that the peak of large molecular weight was not due to a C-terminal extended motilin but to motilin bound to serum proteins and that the tumour contained only the 22-amino acid peptide motilin, which was secreted into the circulation.…”