Stimulation of pancreatic secretion in man by a protease inhibitor (camostate)

Adler, G.; Müllenhoff, A.; Koop, Irmtraut; Bozkurt, T; Göke, Burkhard; Beglinger, Christoph; Arnold, R.

doi:10.1111/j.1365-2362.1988.tb01173.x

Cited by 65 publications

(24 citation statements)

References 17 publications

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“…This study further supports the existence of a negative feedback mechanism between plasma CCK and bile products in the lumen of the proximal small intestine (Adler et al, 1988;Gomez et al, 1988;Koop et al, 1988Koop et al, , 1989. However, other mechanisms of an augmented stimulated CCK release during loxiglumide administration, such as direct effects of loxiglumide on CCK-producing cells or indirect effects via yet to be established paracrine, neurocrine or endocrine mechanisms cannot be excluded.…”

Section: Resultsmentioning

confidence: 67%

Lack of effect of the specific cholecystokinin receptor antagonist loxiglumide on cholecystokinin clearance from plasma in man.

Jebbink

Jansen

Masclee

et al. 1990

Brit J Clinical Pharma

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Saline or loxiglumide (2.5 mg kg-' in 10 min, followed by 5 mg kg-1 h-1 for 200 min) was administered intravenously in random order to six healthy subjects. After 60 min cholecystokinin (CCK-33) was infused (0.5 i.d.u. kg-' h-1 for 1 h then 1.0 i.d.u. kgtl h-1 for 1 h). Loxiglumide did not change basal levels of CCK and did not augment plasma CCKimmunoreactivity during CCK-33 infusion. After cessation of the CCK-infusion, plasma CCK concentrations decreased rapidly to basal values within 12 min, and the elimination half-life during loxiglumide infusion (4.8 ± 0.8 min) was not significantly different from that during saline infusion (4.2 ± 1.0 min). These results suggest that loxiglumide does not interfere with the distribution and metabolism of CCK.

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Section: Resultsmentioning

confidence: 67%

Lack of effect of the specific cholecystokinin receptor antagonist loxiglumide on cholecystokinin clearance from plasma in man.

Jebbink

Jansen

Masclee

et al. 1990

Brit J Clinical Pharma

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show abstract

“…Beside species differences, the use of unsuit able experimental models can be held re sponsible. In some studies trypsin inhibitors were used, which were unable to inhibit Chy motrypsin completely, and therefore unfit to study a presumably protease-specific feed back regulation [14]. The elevated plasma CCK concentrations observed in dogs after application of highly specific receptor antag onists [ 15] do not proof a role for CCK in the feedback mechanism.…”

Section: Discussionmentioning

confidence: 99%

Postprandial Release of Cholecystokinin after Duodenum-Preserving Total Pancreatectomy Is Independent of Intraluminal Pancreatic Protease Activity in Dogs

Guicherit¹,

Gooszen²,

Jansen³

et al. 1990

Digestion

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The effect of meal stimulation, with and without the intraduodenal presence of pancreatic enzymes, on plasma cholecystokinin (CCK) release was studied in order to investigate the role of CCK in the putative feedback mechanism between intraduodenal pancreatic proteases and pancreatic enzyme secretion. Plasma CCK concentrations in response to a semiliquid meal, with and without the supplementation of exocrine pancreatic enzymes, were measured in 8 dogs after duodenum preserving pancreatectomy. With a well-balanced endocrine and exocrine substitution regimen all dogs were kept in good clinical condition, without steatorrhea or significant weight loss, and fasting plasma glucose levels within the normal range. Exocrine supplementation was stopped at least 3 days prior to tests. Basal plasma CCK levels after 3 days without exocrine supplementation (2.5 ± 0.3 pM) did not significantly differ from the results with supplementation (3.0 ± 0.5 pM) nor from the pre-operative levels (2.3 ± 0.3 pM). In addition, integrated plasma CCK responses to the meal without exocrine supplementation (330 ± 37 pM•90min) were not significantly different from the responses to the meal with exocrine supplementation (303 ± 49 pM•90 min), or from the postprandial CCK response in the dogs with an intact pancreas preoperatively (390 ± 100 pM 90 min). It is concluded that the release of CCK in dogs after total pancreatectomy is independent of intraluminal protease activity. It is therefore not likely that CCK mediates the putative feedback mechanism between intraluminal protease activity and pancreatic enzyme secretion in dogs.

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“…This was suggested by us in 1977 [9] when we published the first evidence of the existence of such a mechanism in the human. Today most authors agree that there is a negative feedback mechanism in humans [10][11][12][13][14][15][16][17][18][19]. Although the association to the pain-relieving effect of oral enzyme therapy is not fully established, the hypothesis is that the low trypsin activity in the duodenum in patients with chronic pancreatitis induces an increase in the concen tration of circulating CCK.…”

Section: Oral Pancreatic Enzyme Therapymentioning

confidence: 99%

Pancreatic Pain: Is There a Medical Alternative to Surgery?

Ihse

Andersson²,

Axelson³

1993

Digestion

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The non-surgical management of chronic pancreatic pain is reviewed. In accordance with the suggested multifactorial origin of pancreatic pain, different treatment principles are practised. Besides conventional analgesic drugs, oral pancreatic enzymes seem efficient in a subgroup of patients with chronic pancreatitis. Endoscopic treatment aiming at reduction of the pancreatic duct-tissue pressure is promising, but it is still in its infancy. Coeliac nerve blockage is recommended in patients with pancreatic cancer and pain, whereas external radiotherapy plays a role in a diminishing number of these patients. Treatment of chronic pancreatic pain is an example of a complex clinical problem in which a multidisciplinary approach is mandatory.

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Stimulation of pancreatic secretion in man by a protease inhibitor (camostate)

Cited by 65 publications

References 17 publications

Lack of effect of the specific cholecystokinin receptor antagonist loxiglumide on cholecystokinin clearance from plasma in man.

Lack of effect of the specific cholecystokinin receptor antagonist loxiglumide on cholecystokinin clearance from plasma in man.

Postprandial Release of Cholecystokinin after Duodenum-Preserving Total Pancreatectomy Is Independent of Intraluminal Pancreatic Protease Activity in Dogs

Pancreatic Pain: Is There a Medical Alternative to Surgery?

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