Correlation Between Pancreatic Enzyme Secretion and Plasma Concentration of Human Pancreatic Polypeptide in Health and in Chronic Pancreatitis

Abstract

We have determined the relationship between pancreatic enzyme secretion and release of pancreatic polypeptide in response to nutrient and hormone stimulation in healthy subjects and in patients with different degrees of chronic pancreatitis. In 8 healthy subjects, the output of trypsin, in response to intraduodenal perfusion of an essential amino acid mixture (39.6 ± 3U/h) was significantly higher than that in response to oleic acid (30. 5 ± 1.6 U/h), which in turn was greater than the response to glucose (11.3 ± 2.3 U/h). The relative potencies of the three nutrients in the stimulation of pancreatic polypeptide secretion were similar to those observed for pancreatic enzyme secretion. The integrated pancreatic polypeptide responses were 3206 ± 317, 1954 ± 147, and 1236 ± 117 pg/min · ml for amino acids, oleic acid, and glucose, respectively. The mean (±SE) increase in trypsin output in response to cholecystokinin octapeptide stimulation (35.6 ± 6.4 U/h), was significantly greater than that observed in response to either secretin (9.4 ± 3.0 U/h), or pentagastrin stimulation (10.2 ± 5.9 U/h). The patterns of pancreatic polypeptide responses were similar to those observed for pancreatic trypsin secretion (integrated plasma pancreatic polypeptide response=3127 ± 722; 1261 ± 488; 1207 ± 383 pg/min · ml for cholecystokinin octapeptide, secretin, and pentagastrin, respectively). Over the range of pancreatic enzyme secretion there was a linear relationship between the mean increase in trypsin output in response to each nutrient and the corresponding integrated plasma pancreatic polypeptide response (r = 0.83, p