Trypsin Radioimmunoassay in the Diagnosis of Chronic Pancreatitis

Abstract

Serum immunoreactive trypsin (IRT) determination has been recommended as a screening test in chronic pancreatitis. Using a commercial radioimmunoassay kit (RIA – gnost Trypsin; Behring-Werke, Marburg/Lahn, FRG) the interassay coefficient of variation was 26–44% for three different test sera. Gel filtration chromatography profiles revealed immunoreactivity in the position of ¹²⁵I-trypsin and ( < 50%) in the void volume. The test was evaluated in controls (n = 90), chronic relapsing pancreatitis (CRP;n = 60) and after total pancreatectomy (n = 5). In 65% of the CRP cases decreased IRT values were found, whereas during acute attacks of CRP supranormal and normal values were found. After total pancreatectomy IRT levels were undetectable. It is concluded that the sensitivity of this IRT test is limited and that the available test system needs improvement.

Effect of Atropine and Somatostatin on Bombesin-Stimulated Plasma Immunoreactive Trypsin Release in Man

“…bolus followed by 125 pg/h) also failed to inhibit the plasma trypsin response to bombesin (207 ± 18 to 663 ± 166 ng/ml). These results point to major differences in the regulation of plasma and intraduodenal trypsin secretion.Infusion of bombesin, a gastrointestinal neuropeptide, stimulates the secretion of trypsin not only into the duodenum but also into the circulation nin does not seem to be involved in the stim ulation of immunoreactive trypsin release into the plasma by bombesin [5][6][7], In order to delineate the mechanism of the stimula tory' effect of bombesin on plasma immuno reactive trypsin, we have determined the ef fects of atropine and somatostatin, two in hibitors of intraduodenal pancreatic enzyme secretion, on bombesin-stimulated release of immunoreactive trypsin into the plasma of healthy human subjects. …”

Plasma-Immunoreactive Trypsin in Chronic Renal Failure

“…1). All patients with plas ma creatinine levels exceeding 350jumol/l (4 mg/dl) showed elevated IR T values when compared to levels in controls (1 0 5 -4 8 0 ng/ ml) in a recent study (2).…”

“…None o f these patients had clinical signs or laboratory findings (amylase) o f pancreatic disease. Heparinized plasma was obtained from these patients and IR T was measured using a commercial radio immunoassay kit (Behringwerke, F R G ) as described earlier (2). Normal range (105 480 ng/ml) o f basal IR T levels in our laboratory was established in 90 patients with a normal secretin-pancreozymin test (2).…”

“…Heparinized plasma was obtained from these patients and IR T was measured using a commercial radio immunoassay kit (Behringwerke, F R G ) as described earlier (2). Normal range (105 480 ng/ml) o f basal IR T levels in our laboratory was established in 90 patients with a normal secretin-pancreozymin test (2). l or statistical analysis the t test for paired data and linear regression calculation were used.…”

“…Ele vated levels have been described in acute pancreatitis (1,5) and low levels in chronic pancreatitis (1,2). We have investigated wheth er chronic renal failure alters the levels o f plas ma-immunoreactive trypsin (IR T ) thus masking changes due to concurrent pancreatic disease.…”