Gastrin and its implications in the management of peptic ulcer

Abstract

The structure of gastrin is now known, and all the biological actions are contained in an all-important tetrapeptideamide sequence, which is also present in at least one other hormone of the upper gastrointestinal tract. Undoubtedly the main physiological action of gastrin is the stimulation of the secretion of hydrochloric acid by the stomach, and one of the readily available synthetic small gastrinactive peptides is the agent of choice for tests of maximal acid response for clinical purposes. The diagnostic usefulness of such tests is limited, however. Abnormalities of gastrin production play a definite role in two rare disorders, the Zollinger-Ellison Syndrome and recurrent ulcer due to retained isolated pyloric antrum. The possible contribution of gastrin abnormalities in other clinical situations is uncertain, but the considerable progress in assays, particularly radioimmunoassay of gastrin, will help in resolving these doubts. The spectrum of other actions of gastrin is much wider than originally thought, but at present there is no clear indication of direct clinical application of any of these other effects.