Pancreatic Synthetic Rates: A New Test of Pancreatic Function

Abstract

Synthesis of pancreatic enzymes was measured in 7 patients with chronic pancreatitis and 10 patients with no pancreatic disease, on the basis of the incorporation of 75Se-methionine into pancreatic exocrine proteins. Two of the patients with chronic pancreatitis had normal exocrine function. Pancreatic secretion was stimulated by intravenous infusion of secretin (1 clinical unit x kg-1 x h-1) and cholecystokinin (1 Ivy dog unit x kg-1 x h-1). 75Se-methionine (3.0 microCi x kg-1) was added to the infusion. Synthetic rates were significantly greater in all the patients with chronic pancreatitis, including the two individuals with normal responses to stimulation with secretin and cholecystokinin. Studies of synthetic rates may therefore be able to confirm the diagnosis of chronic pancreatitis before exocrine insufficiency becomes manifest.

Caerulein-induced acute pancreatitis inhibits protein synthesis through effects on eIF2B and eIF4F

“…The effect of AP on pancreatic protein synthesis observed in these and other studies has been less clear, because some studies reported no effect (5,30,55), whereas other studies reported inhibition (17,26,32,36). In the present study, AP was induced in C57BL/6 mice using a caerulein hyperstimulation model involving single or repetitive doses of caerulein (14,45).…”

“…protein translation; mice IT HAS BEEN WELL ESTABLISHED that experimental acute pancreatitis (AP) inhibits pancreatic exocrine secretion (32,36,55,60). It has also been reported that pancreatic protein synthesis is unaffected by AP, leading to accumulation of digestive enzymes (5,30,55,60). However, other studies have shown inhibition of pancreatic protein synthesis in both in vivo experimental AP studies (17,26,32,36,46) and in vitro models of AP using CCK hyperstimulation of isolated acini (31,48,56).…”

Long-Term Outcome of Acute Necrohemorrhagic Pancreatitis

“…Indeed, the S-C test showed a defec tive pancreatic secretion in 40% of the pa tients at the first control, but only in 7% at the second control. This progressive im provement of the exocrine function, noticed also by others [18][19][20], strongly suggests some kind of regeneration of the acinar structures that would be hard to explain in the course of chronic pancreatitis as previously defined, even if a compensatory hypertrophy of the surviving acinar cells has been recently dem onstrated in chronic pancreatitis patients [21], In regard to the ductal lesions visualized at ERP. they could be consistent with chronic pancreatitis.…”

Pancreatic function testing

“…The protein‐bound radioactivity in the duodenal aspirates is used as an index of pancreatic exocrine function. Some studies reported a good separation of healthy controls and patients with chronic pancreatitis, 82 , 83 whereas more recent studies failed to show a sufficient sensitivity for this test 84–86 . The sensitivity and specificity of this test are both considerably less than those of the secretin–cholecystokinin stimulation test, despite being an equally invasive procedure requiring duodenal intubation and exposure to radioactive substances 4 …”