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Effect of the Cholecystokinin-Receptor Antagonist Lorglumide on Pancreatic Enzyme Secretion Gut: First Published As 10.1136/Gut.32.2.215 on 1 February 1991

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Effect of the Cholecystokinin-Receptor Antagonist Lorglumide on Pancreatic Enzyme Secretion Gut: First Published As 10.1136/Gut.32.2.215 on 1 February 1991 Gut, 1991,32,215-219 215 Effect of the cholecystokinin-receptor antagonist lorglumide on pancreatic enzyme secretion Gut: first published as 10.1136/gut.32.2.215 on 1 February 1991. Downloaded from stimulated by bombesin, food, and caerulein, giving similar plasma cholecystokinin concentrations in the dog A J L de Jong, M V Singer, J B M J Jansen, W Niebel, LC Rovati, C B H W Lamers Abstract including the enterohormone cholecystokinin, a This study was undertaken to determine the powerful stimulant of pancreatic enzyme role of cholecystokinin in pancreatic enzyme secretion.36 secretion stimulated by bombesin and a meal It is generally accepted that food stimulates by (a) comparing the pancreatic enzyme output pancreatic enzyme secretion through a delicate during bombesin infusion and after a meal to interplay between nerves and gastrointestinal output during caerulein infusion and (b) hormones.247 Several studies have suggested an comparing the inhibitory effect of the chole- important role for the vagal cholinergic system cystokinin-receptor antagonist lorglumide and for cholecystokinin.27 (CR-1409) on enzyme output in response to The present study was undertaken to deter- bombesin and food with the response to mine the role of cholecystokinin in the caerulein. Bombesin (90 pmollkg per h) and stimulation of pancreatic enzyme secretion by caerulein (30 pmollkg per h) were infused into bombesin and food in the dog by (a) comparing seven dogs in doses giving similar plasma the effects on pancreatic enzyme secretion of cholecystokinin peak increments as a meal similar plasma cholecystokinin concentrations (mean (SEM) 6.8 (0.8), 6-3 (1.2), and 5.7 (0.8) obtained after feeding and after the infusion of pM, respectively), together with either saline bombesin and the synthetic cholecystokinin- or 2 mg/kg per h of A lorglumide. background peptide caerulein and (b) comparing inhibition http://gut.bmj.com/ infusion of synthetic secretin 20.5 pmollkg per by the cholecystokinin-receptor antagonist CR- h was given in each experiment. In addition, 1409 (lorglumide)'9 on bombesin and food stimu- gastric acid secretion was determined in the lated pancreatic enzyme secretion to that during experiments with bombesin and caerulein infusion of caerulein. Since the dogs were infusion. Pancreatic protein responses to equipped with a gastric fistula, which was kept bombesin (1231 (247) mg/h) and food (1430 open during the studies to prevent acid entering (220) mg/h) were similar to the responses to the duodenum, we were also able to study the on September 30, 2021 by guest. Protected copyright. caerulein (1249 (201) mg/h). Lorglumide effect of the cholecystokinin-receptor antagonist inhibited pancreatic protein output during on gastric acid during the infusions of caerulein stimulation with bombesin by 60%, after the and bombesin. meal by 45%, and during caerulein infusion by 68%. Pancreatic bicarbonate output by bombesin, caerulein, and food was inhibited Methods by lorglumide by 28%, 40%, and 38%, respec- Seven mongrel female dogs, each weighing 17- tively. In contrast, lorglumide significantly 32 kg, were fitted with a chronic duodenal fistula Department of increased acid Gastroenterology- gastric secretion from 1.12 to as described by Thomas and a gastric fistula Hepatology, University 7-98 mmol/h during bombesin infusion and using a Thomas-type cannula, modified so that of Leiden, The from 0.52 to 7.62 mmol/h during caerulein the inner flange was circular rather than oval.'0" Netherlands infusion. In conclusion, cholecystokinin plays The duodenal Thomas cannula was placed A J L de Jong an J B M JJansen important part in the stimulation of pan- opposite the main pancreatic duct, while the C B H W Lamers creatic enzyme secretion by bombesin and a accessory pancreatic duct was ligated. Studies meal in conscious dogs and it is involved in the Division of were started four weeks after surgery. Food but Gastroenterology, regulation ofgastric acid during stimulation by not water was withheld for 18 hours before each Department of Medicine, infusions of caerulein and bombesin. test. In each dog a glass cannula connected to a University ofEssen, FRG M V Singer piece of polyethylene tubing was inserted into W Niebel the main pancreatic duct and pancreatic juice Bombesin is a neuropeptide present in the was collected in ice-cold graduated conical tubes. Rotta Research Laboratories, Monza, nerves of the gastrointestinal tract including the The duodenal fistula was then closed by putting Italy duodenum and pancreas of several species.' gauze dipped in soft paraffin around the glass L C Rovati Bombesin-like peptides potently stimulate pan- cannula to avoid leakage of duodenal contents. Correspondence to: creatic enzyme secretion.2-' How bombesin acts After the gastric cannula was opened and the Professor Dr C B H W Lamers, University Hospital on the pancreas has not been fully elucidated. On stomach rinsed with distilled water a polyethy- Leiden, Building 1, C4-PO15, the one hand, receptors for bombesin have been lene tube with a diameter of 10 mm was inserted PO Box 9600, 2300 RC Leiden, The Netherlands. identified on acinar cells ofmost species' 5; on the into the stomach and the fistula was closed in a Accepted for publication other hand, bombesin is known to stimulate the similar way to the duodenal fistula. 30 April 1990 secretion ofseveral gastrointestinal polypeptides, Six experiments, separated by at least one 216 dej7ong, Singer,Jansen, Niebel, Rovati, Lamers Caerulein Bombesin 801 Meal Gut: first published as 10.1136/gut.32.2.215 on 1 February 1991. Downloaded from 7T0 6.0] a v50 g 4-0 0v 30 2.0 1-0. U . - s r r -60 -30 0 30 60 90 120 -60 -30 0 30 60 90 120 -60 -30 0 30 60 90 120 Time (min) Figure 1: Plasma cholecystokinin (CCK) concentrations (mean (SEM), 7 dogs) duringinfusion ofcaerulein (left), intragastric administration ofa meal (middle), and bombesin infusion (right) together with an infusion oflorglumide or saline. week, were performed at random on each of the sulphated tyrosyl region.'2 4 Pancreatic and seven dogs: intragastric administration of a gastric juice were collected continuously and standard test meal and infusions of bombesin separated into 15 minute samples. Volume was and caerulein together with either saline or measured to the nearest 0 1 ml. Concentrations lorglumide (CR-1409; Rotta Research Labora- of protein and bicarbonate were measured as tories, Monza, Italy) were given. All studies were described previously,'5 while gastric acid con- done with an intravenous of 20.5 pmol/kg per h centrations were determined by titration with synthetic secretin (Hoechst AB, Frankfurt, 0-1 M NaOH to pH 7.0. FRG) dissolved in 0-1% dog albumin solution, to Results are expressed as mean (SEM). In the guarantee sufficiently large volumes ofpancreatic three experiments in each dog in which either juice. In preliminary studies the doses of bom- saline or lorglumide was infused before the http://gut.bmj.com/ besin (UCB, Brussels, Belgium) and caerulein -stimulants, the mean of the three results for each (Farmitalia, Milan, Italy) were determined to dog was used for further analysis. Statistical give plasma cholecystokinin concentrations analysis was done by Student's t test for paired similar to those after the meal. The meal, results. consisting of 100 g of liver extract (Murnil) containing 74-3 g protein and 17-3 g fat homo- genised in 400 ml of water, was instilled through Results on September 30, 2021 by guest. Protected copyright. the gastric fistula within 10 minutes to guarantee In the 21 experiments in the seven dogs in which reproducible responses. either saline or lorglumide was infused with the Plasma samples for measurement of chole- secretin infusion alone, no significant differences cystokinin were obtained at 15 minute intervals. were found in pancreatic protein secretion (201 Plasma cholecystokinin was measured by a (54) v 154 (45) mg/h) and bicarbonate secretion specific and sensitive radioimmunoassay as des- (2-3 (0-5) v 2-6 (0-8) mmol/h). cribed previously.2 3 Antibody T204 was used, Plasma cholecystokinin peak increments were which showed equal binding to carboxy-terminal similar in response to the three stimulants: 6-8 cholecystokinin peptides containing the (0-8) pM during bombesin infusion, 5-7 (0-8) Caeru lein Bombesin 600 RA---m-1eal e ( )Saline 9 0 R 1409 LC) ~~~~~~~~~~~~~~~~~~~~~C ~'400- 300, 0 200- 100 00 -60 -30 6 30 60 90 120 -60 -30 6 30 60 90 120 -60 -3 0 30 6 90 120 Time (min) Figure 2: Pancreatic protein output (mean (SEM), 7 dogs) during infusion ofcaerulein (left), intragastric administration ofa meal (middle), and bombesin infusion (right) together with an infusion oflorglumide or saline. Effectofthe cholecystokinin-receptor antagonist lorglumide onpancreatic enzyme secretion stimulated by bombesin, food, andcaerulein 217 Caerulein Bombesin Gut: first published as 10.1136/gut.32.2.215 on 1 February 1991. Downloaded from | Saline lo CR 1409| 0 E E a0 .2 UOCD 0 -60 -30 0 30 60 90 120 -60 -30 0 30 60 90 12( Time (min) Figure 3: Gastric acid output (mean (SEM), 7 dogs) during infusion ofcaerulein (left) or bombesin (right) together with an infusion oflorglumide or saline. pM after the standard test meal, and 6.3 (1 2) pM significant), afterthe testmeal to 7.3 (1 7) mmol/h during caerulein infusion (Fig 1). (p<O0O5), and during caerulein infusion to 3.5 Infusion of bombesin increased pancreatic (0.9) mmol/h. The relative inhibition of pan- http://gut.bmj.com/ protein output from 149 (39) to 1231 (247) mg/h creatic bicarbonate output by lorglumide was not (p<0005); the standard test meal increased significantly different during administration of pancreatic protein secretion from 221 (62) to the three stimuli: 28% during infusion of bom- 1430(220) mg/h (p<0O01), and caerulein infusion besin, 38% after the test meal, and 40% during increased pancreatic protein secretion from 220 caerulein infusion.
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