Abstract
An intravenous injection of insulin represents a powerful stimulus for secretion of gastric acidl 8• The action of insulin arising through the central stimulative effect of hypoglycemia on the cerebral vagal centers5 differs from humoral and peripheral vagotropic stimuli which act directly upon parietal cells or peripheral autonomic ganglia. This difference of action found application in a test for determining the thoroughness of vagotomy9, 10 as well as in tests to evaluate the vagal mechanism of gastric secretionU 13 and for testing the functional status of all cellular secretory elements of gastric glands14. The last application of insulin is possible because it represents the most comprehensive gastric secretory stimulus known, for its action is not limited to an evocation of hydrochloric acidl 8 but it also affects pepsin12, 16, 16 and gastric mucoprotein16 , 18. The negative results obtained by some authors12, 17 in respect to the influence of insulin on gastric mucin components are now known to depend upon an inadequate technic for mucin determination18. Recently gastric mucoprotein has been separated from the total dissolved mucin of human gastric juice18 , 19. Being probably identical with the mucoprotein isolated from canine gastric juice after sham feeding20 human gastric mucoprotein is closely related to but different from gastric pepsin16, 21. Gastric mucoprotein has nothing in common with the secretion of surface epithelium, i.e. the visible surface epithelium mucus and its dissolution and split product, the dissolved gastric mucoproteose19 , 22. Apparently it is a secretory product of the gastric glands located in the fundus and body of the stomach and it is strongly under direct vagal influence18. Testing the mucoprotein and acid response to insulin has been suggested as a new test for evaluation the secretory status of the fundal glands23, and various patterns of mucoprotein and acid response to insulin were observed23 , 24: a) positive pattern characterized by a rise in mucoprotein concentration and gastric acidity; b) dissociated pattern characterized by a positive mucoprotein and negative acid response to insulin; c) negative pattern characterized by a negative response of mucoprotein and acid to insulin. In the present paper an attempt will be made to correlate the results of this test with the underlying gastric pathology in the nonoperated normal and pathological stomach.
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