The response of the lower oesophageal sphincter to maximal doses of pentagastrin

Trindade, Leda Maria Delmondes Freitas; Rosenberg, I. L.; Rózycki, Z; Giles, G. R.

doi:10.1002/bjs.1800620104

Cited by 7 publications

(4 citation statements)

References 19 publications

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“…Firstly, the action should be achieved with concentrations of the hormone which are submaximal for its primary action; secondly, the exogenous hormone given in physiological doses should produce the effect in question; and thirdly, the action should be observed following physiological release of the hormone. While the present results and those reported by others fulfil the first of these criteria (Giles et al, 1969;Cohen and Lipshutz, 1971;Freeland et al, 1975;Trindade et al, 1975;7 Kaye et al, 1976), the second is disputed (Freeland et al, 1975;Jensen et al, 1977), and the third, which is the most important, is not fulfilled. In consequence, we believe that presently available evidence supports the opinion of Grossman (1973) that the action of gastrin on the LOS is pharmacological rather than physiological.…”

Section: Discussioncontrasting

confidence: 62%

“…There is no doubt that exogenous gastrin increases sphincter pressure (Giles et al, 1969;Cohen and Lipshutz, 1971;Trindade et al, 1975;Kaye et al, 1976) but the evidence that endogenous gastrin is a physiological determinant of sphincter pressure is less convincing (Grossman, 1973;Roszkowski et al, 1973;Farrell et al, 1974;McCall et al, 1975;Dodds et al, 1975a, b;Dent and Hansky, 1976). Central to the controversy is the methodology of LOS pressure measurement.…”

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confidence: 99%

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Lower oesophageal sphincter response to gastrin--pharmacological or physiological?

Henderson¹,

Lidgard²,

Osborne³

et al. 1978

Gut

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SUMMARY The response of the lower oesophageal sphincter (LOS) to intragastric instillation of protein was assessed in 10 healthy volunteers. Sphincter pressures were measured by a rapid pullthrough technique and serum gastrin concentrations during each test were determined by radioimmunoassay. Despite stimulation of gastrin release by protein instillation, no significant change in LOS pressure was observed. However, intravenous pentagastrin (0 25 and 0.5 jig/kg) produced an immediate increase in sphincter pressure, which then returned to the basal level within four minutes. Thus, although pentagastrin is an effective pharmacological stimulant of the sphincter, endogenous gastrin appears not to be a physiological determinant of LOS pressure in man.The role of endogenous gastrin in control of the lower oesophageal sphincter (LOS) is still a subject of controversy. There is no doubt that exogenous gastrin increases sphincter pressure (Giles et al., 1969;Cohen and Lipshutz, 1971;Trindade et al., 1975;Kaye et al., 1976) but the evidence that endogenous gastrin is a physiological determinant of sphincter pressure is less convincing (Grossman, 1973;Roszkowski et al., 1973;Farrell et al., 1974;McCall et al., 1975; Dodds et al., 1975a, b;Dent and Hansky, 1976). Central to the controversy is the methodology of LOS pressure measurement. Most studies have used static pressure recording catheters or a station pull-through technique in which the recording catheter is withdrawn across the sphincter in 1 cm steps, pausing after each step to record LOS pressure during three or four respiratory cycles. Rapid pull-through techniques are now available which minimise error in pressure recording (Dodds etal., 1975a(Dodds etal., , b 1976) and a rapid pull-through method was used in the present study to measure the LOS pressure response to endogenous gastrin release provoked by intragastric instillation of protein. Methods TECHNIQUE OF LOS PRESSURE MEASUREMENT LOS pressure was measured by a rapid pull-through technique based on that described by WaldeckReceived for publication 9 August 1977 (1972) and modified by Osborne and his colleagues (1977). Recordings were made with a single lumen polyvinyl tube which was perfused at 6 ml/min as it was withdrawn across the LOS at 0'9 cm/s. This system was capable of recording a pressure rise rate of 70 mmHg/s when tested on the bench. By convention, LOS pressure is measured as the peak height of the profile relative to intragastric pressure. RESPONSE OF LOS TO PENTAGASTRINFour healthy male volunteers (aged 26-32 years), without a previous history of dyspepsia, were given graded doses of pentagastrin (Peptavlon, ICI) to determine the LOS pressure response. Doses of 0'0625, 0 125, 0-25, and 0 5 jig/kg were used, the pentagastrin being diluted in 10 ml/150 mm sodium chloride solution and injected intravenously over 60 seconds. The four doses were given in a random order which was not known to the subject. LOS pressure was measured every two minutes for 10 minutes before pentagastrin injectio...

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Section: Discussioncontrasting

confidence: 62%

mentioning

confidence: 99%

Lower oesophageal sphincter response to gastrin--pharmacological or physiological?

Henderson¹,

Lidgard²,

Osborne³

et al. 1978

Gut

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“…The demonstrations that human LOS pressure could be modified by gastric infusions of acid and alkali (Castell and Harris, 1970;Beiles et al, 1972;Castell and Levine, 1972;Higgs et al, 1974); that LOS pressure could be consistently increased by gastrin and pentagastrin (Giles et al, 1969;Castell and Harris, 1970;Cohen and Lipshutz, 1971;Lipshutz et al, 1973;Siewert et al, 1974;Trindade et al, 1975); and that LOS pressure in the opossum could be drastically diminished by the use of gastrin antiserum (Lipshutz, et al, 1972) led to the proposal that gastrin was of primary importance in the regulation of LOS pressure. Recent studies, however, have cast considerable doubt upon the physiological relevance of gastrin in this context (Grossman, 1973;Sturdevant and Kun, 1973;Farrell et al, 1974;Goyal and McGuigan, 1975;Walker et al, 1975).…”

mentioning

confidence: 99%

Responses of the competent and incompetent lower oesophageal sphincter to pentagastrin and abdominal compression.

Kaye¹,

Rein²,

Johnson³

et al. 1976

Gut

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The central role of the physiological lower oesophageal sphincter (LOS) in the prevention of gastro-oesophageal reflux is now well recognised; and, in recent years, the effects upon resting LOS pressure of a number of hormones and drugs have been defined (Castell, 1975). However, the physiological means by which resting pressure within the LOS is maintained and modulated have not been fully elucidated; nor have the factors responsible for sphincteric incompetence, and therefore gastro-

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“…Gastrin has been the best studied and yet the most controversial hormone for its effect on the LES (Cohen, Long and Snape 1979). The demonstration that exogenous pentagastrin enhanced the LES pressure (Kaye, Rein, Johnson and Showalter 1976;Trinidade, Rosenberg, Rozycki and Giles 1976) led to the suggestion that endogenous gastrin exerted a role in the regulation of the LES. I.v.…”

Section: Discussionmentioning

confidence: 99%

Effect of Somatostatin on Lower Esophageal Sphincter (LES) Pressure and Serum Gastrin in Normal and Achalasic Subjects

Greco¹,

Bianco²,

Altomonte³

et al. 1982

Horm Metab Res

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Serum gastrin and lower esophageal sphincter (LES) responses to somatostatin infusion were evaluated in ten normal subjects and in nine achalasic patients in order to determine evidence of hormonal (presumably gastrin)control of LES pressure. After somatostatin infusion, a significant decrease of serum gastrin was observed in normal subjects at 30 min (81.6 +/- 3.2 versus 40.0 +/- 4.7 pg/ml; p less than 0.01) and a rapid increase of LES pressure was also observed (26.0 +/- 1.3 versus 34.1 +/- 1.6 mmHg; p less than 0.01). In achalasia no change was observed in serum gastrin concentration after somatostatin infusion. LES pressure at 20 min however significantly decreased (45.8 +/- 7.6 versus 31.6 +/- 2.3 mmHg; p less than 0.05). Endogenous gastrin is not a major control factor for LES pressure in either normal or achalasic subjects.

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The response of the lower oesophageal sphincter to maximal doses of pentagastrin

Cited by 7 publications

References 19 publications

Lower oesophageal sphincter response to gastrin--pharmacological or physiological?

Lower oesophageal sphincter response to gastrin--pharmacological or physiological?

Responses of the competent and incompetent lower oesophageal sphincter to pentagastrin and abdominal compression.

Effect of Somatostatin on Lower Esophageal Sphincter (LES) Pressure and Serum Gastrin in Normal and Achalasic Subjects

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