Quantitative assessment of exocrine pancreatic function in infants and children

Hadorn, B; Zoppi, G; Shmerling, D. H.; Prader, A.; McIntyre, Iain M.; Anderson, Charlotte M.

doi:10.1016/s0022-3476(68)80037-x

Cited by 171 publications

(59 citation statements)

References 27 publications

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“…This relationship may be taken to indicate that protein is washed free from the pancreatic ductal system. This same type of relationship has been observed previously in humans undergoing CCK-secretin pancreatic function tests (1, 4,20). This relationship, however, was not observed in the treated animals.…”

Section: Protein and Amylasesupporting

confidence: 85%

Pancreatic Function in the Reserpinized Rabbit—a Model for Cystic Fibrosis. I. Effect of Secretin

1982

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Summaryby CF, ~ancreatic secretions have not been as extensively studiedPancreatic juice was collected from rabbits treated with reserpine and from untreated controls. The volume of pancreatic juice secreted, flow rate and the bicarbonate output were all significantly reduced in the treated animals during both spontaneous flow and during secretin-stimulated flow. On the other hand, the total protein concentration, the amylase activity and the calcium concentration of the pancreatic juice were all significantly elevated in the treated animals. The elevation in the total protein concentration appeared to be due to both increased amounts of protein and decreased amounts of water. Of particular interest was that secretin stimulation caused the same % increase in the flow rate and output of pancreatic juice in both control and reserpine treated rabbits. he method-by which fluid is secreted by-the treated animal, therefore, appeared to be depressed at all times and under all conditions. Decreased volumes of pancreatic juice, a decreased bicarbonate output and increased concentrations of protein and calcium are found in this model and are consistent with clinical findings present in the pancreatic secretions obtained from individuals with cystic fibrosis. Therefore, the similarities between secretions of the reserpine treated rabbit and those observed in the cystic fibrosis patient support its use as an experimental model for investigating the abnormal pancreatic secretions in this disease. SpeculationRabbits treated with reserpine for 7 days secrete smaller volumes of pancreatic juice at lower rates of flow during both spontaneous and secretin-stimulated conditions. This juice contains elevated levels of total protein, enzymes, calcium and smaller amounts of bicarbonate. Because these alterations are common in patients with CF, the reserpine-treated rabbit appears to be a good model to investigate the perturbations taking place in the pancreas during the course of this disease.The study of cystic fibrosis (CF) has been hampered by the lack of an equivalent disease in a lower species. For this reason attempts have been made to pharmacologically perturb the exocrine secretions of an experimental animal to the point where they resemble what is seen in this disease (8,10). One such model is the chronically reserpinized rat. Rats treated for several days with reserpine develop morphologic and secretory changes in the submaxillary gland (9, 11) and in the pancreas (6, 16) which resemble those present in CF patients. The Na+ transport inhibitory factor, present in the saliva of CF patients (7) has been demonstrated in the saliva of reserpinized rats as well (13). In addition, this treatment increases the pulmonary secretion of phospholipids (14), total protein (21) and of a specific type of glycoprotein which is also present in lung lavages of CF patients (21). These alterations seem to indicate that reserpinization creates a generalized exocrine gland dysfunction resulting in a fairly complete animal model with which this d...

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Section: Protein and Amylasesupporting

confidence: 85%

Pancreatic Function in the Reserpinized Rabbit—a Model for Cystic Fibrosis. I. Effect of Secretin

1982

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“…Inasmuch as amniotic fluid is devoid of starch, it is not surprising that amylase activity has not been detected in the fetal pancreas (45,46). In fact, amylase was not detectable in the neonatal pancreas either (46,47), but did increase during the first year (48). Consistent with this developmental process, we were unable to detect expression of the amylase gene in the fetal pancreas, although high levels of amylase transcripts were detected in the pancreas of the 11-mo-old child and the adult.…”

Section: Discussionmentioning

confidence: 99%

Developmental Gene Expression in the Human Fetal Pancreas

et al. 1994

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Differential developmental regulation of pancreasspecific genes has not been reported for the human fetal pancreas. We have therefore undertaken a systematic, quantitative analysis of the transcriptional levels of various genes in the human pancreas at different stages of fetal and postnatal development. Using sensitive ribonuclease protection assays, in situ hybridization, and the polymerase chain reaction, our results indicate the following: 1 ) Transcriptional levels of insulin and amylin remain lower in the fetal than in the adult pancreas, whereas glucagon and somatostatin mRNA levels are consistently greater after 14 wk gestation than postnatally. These results are in agreement with previous immunohistochemical studies of these gene products.2 ) The reg gene exhibits a 20-fold increase in mRNA levels after 16 wk gestation. The gene is expressed exclusively in the acinar cells and does not colocalize with insulin. This restricted exocrine expression does not indicate a direct role for the reg gene in islet development. 3 ) Glucose transporter 2 and glucokinase mRNA are detectable as early as 13 wk gestation and remain low throughout development. Glucose transporter 1 reaches adult transcriptional levels by 18 wk gestation. The early detection of glucose transporter 2 and glucokinase implies that lack of expression of these "glucose sensor" genes does not account for the known insensitivity of the fetal p-cells to glucose. (Pediafr Res 36: 537-544, 1994)

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“…We started sampling only if the duodenum was completely isolated from the stomach and the jejunum, i.e., if 4-5 ml air introduced into the lumen could be completely recovered. After an initial collection of duodenal juice for 10-20 min, exocrine pancreas secretion was stimulated, as in our previous investigations [9,22,23], with pancreozymin [25] and 20 min later with secretin [25]. Both hormones were administered by slow intravenous injection (1 min).…”

Section: Duodenal Intubationmentioning

confidence: 99%

Exocrine Pancreas Function in Premature and Full Term Neonates

et al. 1972

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ExtractPancreatic response to pancreozymin and secretin stimulations has been studied in premature and full term neonates. The following results have been obtained. (7) At birth premature neonates have a fairly well developed exocrine pancreatic function which is, however, lower than that of full term neonates. (2) One week after birth, exocrine pancreatic activity becomes higher in premature than in full term neonates.(3) Early administration of small amounts of starch stimulates pancreatic a-amylase (EC. 3.3.1.1) production. (4) A high protein diet stimulates increased production of both trypsin (EC. 3.4.4.4) and lipase (EC. 3.1.1.3), whereas a high fat diet alone has no effect on lipase secretion. SpeculationExocrine pancreatic function is fairly well developed in premature neonates from 32-week gestation, although it is less developed at birth than it is in full term neonates and in older infants and children. After birth, the more rapid maturation of the exocrine pancreas function of premature neonates is probably related to the functional demands of a more rapid growth. The rates of maturation of secretion of a-amylase and trypsin increase proportionately to the starch and protein contents of the diet. The use of an appropriate diet therefore seems to be of great importance in regulating the secretions of the exocrine pancreas during the first month of life.

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Quantitative assessment of exocrine pancreatic function in infants and children

Cited by 171 publications

References 27 publications

Pancreatic Function in the Reserpinized Rabbit—a Model for Cystic Fibrosis. I. Effect of Secretin

Pancreatic Function in the Reserpinized Rabbit—a Model for Cystic Fibrosis. I. Effect of Secretin

Developmental Gene Expression in the Human Fetal Pancreas

Exocrine Pancreas Function in Premature and Full Term Neonates

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