Is somatostatin a humoral regulator of the endocrine pancreas and gastric acid secretion in man?

The effect of low dose infusions of somatostatin on meal stimulated gastric acid secretion was studied in eight healthy volunteers by intragastric titration after a peptone test meal with radioimmunoassay control of the plasma concentrations of somatostatin and the pancreatic hormones glucagon and insulin. Infusion of somatostatin in a dose of 100 ng/kg/h, resulting in a plasma concentration of 13.4 +/- 2.1 pmol/l, inhibited acid secretion significantly, and in a dose of 800 ng/kg/h, with corresponding plasma concentration of 66.5 +/- 12.0 pmol/l the acid secretion was virtually abolished. Plasma concentrations of insulin and pancreatic glucagon decreased significantly during infusion of 200 ng/kg/h (24.5 +/- 7.5 pmol/l) and glucose concentrations increased. Serum gastrin was only significantly decreased during the highest dose of somatostatin. The range of plasma somatostatin concentrations obtained with the lower doses correspond to reported physiological variations. The results support the concept that somatostatin participates in the hormonal control of the pancreatic endocrine and the acid secretion.

Regulatory peptides in the lower esophageal sphincter of man

Smooth muscle specimens were taken from the lower esophageal sphincter of patients suffering from achalasia or hiatus hernia with gastro-esophageal reflux. The specimens were analysed for neurohormonal peptides using immunochemistry and immunocytochemistry. Control specimens were obtained from patients subjected to esophageal resection because of esophageal cancer. The concentration of vasoactive intestinal polypeptide (VIP) was higher and the VIP nerve supply greater in patients with hiatus hernia than in control patients. The VIP nerve supply and the content of this peptide was lower in patients with achalasia than in controls. The same tendency was observed for substance P and enkephalin although the changes in their concentrations were not statistically significant. Enkephalin fibers were few, both in specimens from control patients and from patients with hiatus hernia; they could not be detected in specimens from patients with achalasia. Never fibers containing somatostatin or gastrin/cholecystokinin could not be detected in any of the groups and somatostatin and gastrin/cholecystokinin could not be measured in extracts of the lower esophageal sphincter. We propose that changes in the concentration of neuropeptides may at least contribute to manifestations of achalasia and of decreased lower esophageal sphincter pressure and gastro-esophageal reflux.

Gastrin-releasing peptide: effect on exocrine secretion and release from isolated perfused porcine pancreas

The effect of gastrin-releasing peptide (GRP) on pancreatic exocrine secretion was studied by infusing it at four dose levels (0.01, 0.1, 1.0, and 10 nmol/l) into the arterial line of the isolated perfused porcine pancreas. At 1.0 nmol/l GRP stimulated protein (37-fold), fluid (13-fold), and bicarbonate secretion (12-fold). Atropine at 1 mumol/l diminished the protein secretion in response to infusion of GRP at a dose of 1 nmol/l to 45% of control. Fluid and bicarbonate responses were not affected by atropine treatment. Electrical stimulation of the vagus nerves resulted in an increase in pancreatic output of GRP and a concomitant stimulation of exocrine secretion. Infusions of acetylcholine, carbachol, pilocarpine, or dimethylphenylpiperazinium had no effect on the output of GRP, although hexamethonium abolished the response to vagal stimulation. It is concluded that GRP in conjunction with acetylcholine is likely to play a prominent part in parasympathetic regulation of pancreatic exocrine secretion.

A glucose-dependent mechanism in jejunum inhibits gastric acid secretion: a response mediated through enteroglucagon?

In healthy subjects iso- and hyper-tonic glucose or saline was instilled intrajejunally and the effect on gastric acid secretion determined. Iso- and hyper-tonic glucose (100 ml; 300, 600, 900, 1200 mosm) reduced acid secretion dose-dependently (p less than 0.05), whereas iso- and hyper-tonic saline (100 ml; 300, 1000, 1500 mosm) was without influence. The enteroglucagon plasma levels increased during intrajejunal glucose but not during saline infusion. Gastrin and pancreatic glucagon levels were not affected. Hence, our results substantiate the concept of a non-osmosensitive, glucose-specific inhibitory mechanism of acid secretion located in the jejunum. Furthermore, enteroglucagon could be a possible humoral mediator of the inhibition.

Distribution and molecular forms of peptides containing somatostatin immunodeterminants in extracts from the entire gastrointestinal tract of man and pig

Specimens from human porcine mucosal and muscular tissue from the entire gastrointestinal tract were extracted in acid ethanol, subjected to chromatography and analysed for somatostatin-like immunoreactivity by region-specific radioimmunoassays. The concentration of somatostatin-like immunoreactivity from man and pig ranged from 1.13 +/- 0.37 to 101.15 +/- 33.93 pmol/g wet weight, and from 7.64 to 159.48 +/- 23.79 pmol/g wet weight, respectively. In both species the highest concentrations were found in the jejunum. The immunoreactivity in intestinal mucosal extracts was distributed among four major peaks, two of which were identified by HPLC as somatostatin 1-28 and somatostatin 1-14, respectively. A peak of approx. 10 kDa was resolved by ion exchange plus HPLC into three components, two containing at least part of the somatostatin 1-14 sequence as well as (part of) the somatostatin 1-28(1-14) sequence (but differing in charge), the third containing only the 1-28(1-14) sequence. These peptides probably represent uncleaved and partially cleaved prosomatostatin. The fourth component to be identified by gel filtration was slightly larger than somatostatin 1-14. Extracts from the antrum, the pancreas and from muscular tissues contained almost exclusively somatostatin 1-14, and very little somatostatin 1-28, indicating that the somatostatin precursor is processed differently at these sites. Furthermore, extracts of porcine gastric antrum, analysed for somatostatin 1-28(1-14) immunoreactivity, showed two immunoreactive forms in the mucosa and three major forms in the muscular layers.

Glicentin is present in the pig pancreas

Specimens from porcine pancreas and ileal mucosa were extracted in acid/ethanol, subjected to gel permeation chromatography, ion-exchange chromatography, enzymatic peptide degradation, reverse-phase HPLC, and analysed for glucagon-like and glicentin-like immunoreactivity by region-specific radioimmunoassays. Results obtained with all methods were consistent with the hypothesis that glicentin is present in the pig pancreas in small amounts.

On the contamination of commercially available aprotinins with pancreatic islet peptides

Contamination of aprotinins with immunoreactive insulin, glicentin, glucagon, somatostatin, pancreatic polypeptide and pancreatic polypeptide-icosapeptide was estimated by radioimmunoassay. High somatostatin concentrations were found in two commercial preparations. Influence of somatostatin contamination of aprotinins on the clinical as well as the laboratory applications of aprotinin may thus be anticipated.

Effect of vasoactive intestinal polypeptide and somatostatin on secretion of epidermal growth factor and bicarbonate from Brunner's glands

The effect of VIP and somatostatin on secretion of epidermal growth factor and bicarbonate from Brunner's glands was investigated in the rat. Vasoactive intestinal polypeptide infused in doses of 10 and 100 ng/kg/h significantly increased epidermal growth factor and bicarbonate output, but the concentrations did not change. Somatostatin infused at doses of 1, 10, 100 and 1000 ng/kg/h against a background of VIP 100 ng/kg/h inhibited in dose-dependent fashion the stimulated epidermal growth factor and bicarbonate outputs from rat Brunner's gland pouches. Also basal secretion was inhibited by somatostatin. Infusion of antisomatostatin serum stimulated Brunner's gland secretion. By immunohistochemical studies of rat duodena, it was found that epidermal growth factor, is almost exclusively present in the secretory cells of Brunner's glands. It is concluded that VIP stimulates secretion of epidermal growth factor and bicarbonate from Brunner's glands, an effect which is inhibited by somatostatin. A possible role for somatostatin in the control of Brunner's gland secretion is suggested.

The heterogeneity of gastric inhibitory polypeptide in porcine and human gastrointestinal mucosa evaluated with five different antisera

The Sephadex G-50 gel filtration profile of immunoreactive gastric inhibitory polypeptide (GIP) in porcine and human gastrointestinal mucosa was determined in assays with antisera obtained from five different groups working with GIP. Tissue was extracted in acid ethanol or using a boiling method. Three well-defined components were detected with three of the antisera: one component corresponding to natural porcine GIP (5 kDa GIP), one component corresponding to what has been called 8 kDa GIP, and one component somewhat larger than the latter. One antiserum did not measure 8 kDa GIP at all, while the fifth antiserum measured small amounts of 8 kDa GIP in porcine but not in human extracts. While the antisera measured the same amounts of GIP in porcine extracts, two of the antisera measured significantly more GIP than the remaining three in extracts of human mucosa. The elution position of human 5 kDa GIP differed significantly from that of porcine 5 kDa GIP. In addition to the identification of a new molecular form of GIP, and the demonstration of important specificity differences among GIP antisera currently in use, the present results indicate that human and porcine 5 kDa GIP differ in chemical composition.

Gastrin-releasing peptide: pharmacokinetics and effects on gastro-entero-pancreatic hormones and gastric secretion in normal men

Gastrin-releasing peptide (GRP) was infused at two dose levels [GRP I (0-30 min): bolus dose of 1.41 pmol kg-1, followed by 0.12 pmol kg-1 min-1; GRP II (30-60 min): bolus dose of 5.67 pmol kg-1, followed by 1.50 pmol kg-1 min-1] to six normal men to study the pharmacokinetics of GRP using a newly developed RIA and the effect of GRP on gastro-entero-pancreatic hormones and gastric acid secretion. The half-life of disappearance of GRP was 2.8 +/- 0.4 min (+/- SEM). The MCR and the apparent space of distribution were 33.0 +/- 4.0 ml kg-1 min-1 and 133 +/- 31 ml kg-1, respectively. GRP stimulated the secretion of gastrin, pancreatic polypeptide, insulin, glucagon, and glucose-dependent insulinotropic polypeptide in a dose-dependent manner. Gastric acid secretion was stimulated 15 min after the increase in gastrin secretion, suggesting that GRP stimulated gastric acid secretion via release of gastrin. GRP had no significant effect on the secretion of enteroglucagon or neurotensin. In the mammalian gastrointestinal tract, GRP is localized exclusively to nerve tissue. This fact and its potent effects demonstrated here make it a likely candidate for peptidergic nervous control of gastrointestinal function.

Radioimmunoassay, pharmacokinetics, and neuronal release of gastrin-releasing peptide in anesthetized pigs

Using a newly developed radioimmunoassay for porcine gastrin-releasing peptide in plasma, we studied the pharmacokinetics of this peptide after infusing it into pigs at two dose levels. The disappearance of the peptide from plasma was characterized by two components, a fast one (t 1/2 1.4 min) and a slow one (t 1/2 6.6 min). With the same assay the release of gastrin releasing-peptide from the stomachs of 8 pigs that had been catheterized for selective sampling of fundic and antral blood was studied during vagal and splanchnic stimulation with or without acute adrenalectomy at neutral, acidic, and alkaline intragastric pH. Electrical stimulation of the vagal nerves resulted in a marked increase in both antral and fundic gastrin-releasing peptide release, whereas splanchnic stimulation was without effect. The effects of nerve stimulation were neither influenced by intragastric pH nor by adrenalectomy. Because of its presence in nerves in all layers of the gastric wall, its potent effect on gastrin release, and its release after vagal stimulation, gastrin-releasing peptide is likely to play a role in the vagal control of gastrin release, gastric motility, and acid secretion.

Vasoactive intestinal polypeptide (VIP) in the pig pancreas: role of VIPergic nerves in control of fluid and bicarbonate secretion

Vasoactive intestinal polypeptide (VIP) in the pig pancreas is localized to nerves, many of which travel along the pancreatic ducts. VIP stimulates pancreatic fluid and bicarbonate secretion like secretin. Electrical vagal stimulation in the pig causes an atropine-resistant profuse secretion of bicarbonate-rich pancreatic juice. In an isolated perfused preparation of the pig pancreas with intact vagal nerve supply, electrical vagal stimulation caused an atropine-resistant release of VIP, which accurately parallelled the exocrine secretion of juice and bicarbonate. Perfusion of the pancreas with a potent VIP-antiserum inhibited the effect of vagal stimulation on the exocrine secretion. It is concluded, that VIP is responsible for (at least part of) the neurally controlled fluid and bicarbonate secretion from the pig pancreas.

Effect of secretin and glucagon on Brunner's gland secretion in the rat

Brunner's gland secretion in response to infusion of secretin and glucagon was studied in the rat. Secretin was infused in doses of 15, 150 and 1500 ng/kg/h. All dose significantly increased bicarbonate and protein output and depleted Brunner's glands of PAS-positive mucin. Bicarbonate secretion was related to plasma secretin concentration, and a marked stimulatory effect of secretin was found in very low, probably physiological, plasma concentrations. Maximal bicarbonate output was obtained at a plasma concentration of secretin about 20 pmol/l. Glucagon was infused at a rate of 1.0 micrograms/kg/h and did not influence secretion rate or cell morphology. Also large doses of 5.0 and 50.0 micrograms/kg/h had no effect on Brunner's gland secretion. It is concluded that secretin in very low plasma concentrations stimulates secretion of bicarbonate, protein and mucus from Brunner's glands in the rat, while glucagon has no effect, and it is suggested that secretin may be involved in the physiological regulation of Brunner's gland secretion.

Glucagon-related peptides in the human gastrointestinal mucosa

We studied the chromatographic profile and the distribution of glucagon-related peptides in the human gastrointestinal mucosa, using radioimmunoassays directed against the glucagon 6-15 and 19-29 sequences, and against the glicentin sequences 15-30 and 61-69, and a radioreceptor assay for glucagon. Very small amounts of glucagon-related peptides were found in the gastric mucosa, whereas at least four different components could be identified in the distal intestine. One component (mean concentration 130 pmol/g ileal mucosa) is similar to porcine glicentin for size and C-terminal extension, but differs from the glucagon part of the molecule in the N-terminal extension. A second component (mean concentration 131 pmol/g) is probably identical to porcine peak II enteroglucagon (glicentin 33-69), and a third component (7.9 pmol/g) seems to be identical with glucagon. A fourth component containing the glucagon sequence plus an N-terminal extension was also identified (1.7 pmol/g). Thus the human intestinal mucosa contains large amounts of peptides containing the glucagon sequence; at least one of these probably also possesses glucagon-like bioactivity. The proposed structures of the four components are consistent with the base sequence of the first half of the human glucagon gene.

Autonomic nervous control of pancreatic somatostatin secretion

We studied the autonomic nervous control of pancreatic somatostatin secretion using isolated perfused pig pancreases prepared with either intact vagal or splanchnic nerve supply. Electrical stimulation of the vagus nerves increased pancreatic protein output 59-fold, whereas somatostatin output decreased to 57% of prestimulatory secretion. Acetylcholine mimicked the somatostatin response to vagal stimulation, and atropine abolished the inhibition. Splanchnic nerve stimulation increased perfusion pressure up to threefold, whereas somatostatin output decreased to 68%. Phenoxybenzamine abolished the pressure response to splanchnic nerve stimulation and reversed the inhibition to a 20% increase in somatostatin output. Propranolol did not influence the inhibitory effect of splanchnic stimulation but abolished the increase seen after phenoxybenzamine. It is concluded that both divisions of the autonomic nerve supply to the pancreas are inhibitory to somatostatin secretion, but increased secretion may be brought about by a beta-adrenergic mechanism.

Circulating glucagon after total pancreatectomy in man

In five totally pancreatectomized human subjects the secretion of gut-derived glucagons was stimulated by ingestion of a meal rich in fat and carbohydrates. Glucagon-like immunoreactivity in plasma, measured with an antiserum against the 6-15 sequence, increased fivefold in response to the meal. Glucagon like immunoreactivity measured with a antiserum against the C-terminal sequence was initially normal (12-13 pmol/l), increased slightly (to 20 pmol/l), and then decreased (to approximately 6 pmol/l). The chromatographic profile of glucagon-like immunoreactivity in plasma at maximum stimulation was studied after concentration by affinity chromatography. Both assay systems identified two peaks (at Kd-values of 0.30 and 0.60-0.65, and 0.30 and 0.70, respectively). The position at Kd 0.70 corresponds to that of glucagon 1-29. The same components may be identified in plasma from normal subjects. It is concluded that the human intestine is capable of generating all of the molecular forms of glucagon which normally are present in plasma.

The physiological effects of insulin-induced hypoglycaemia in man: responses at differing levels of blood glucose

The aim of this study was to describe hormonal, cardiovascular and thermoregulatory responses to insulin-induced hypoglycaemia of differing levels of severity. Five normal male volunteers were rendered hypoglycaemic at intervals of 1 week by intravenous infusions of 3, 4 or 6 units of insulin/h, or by intravenous injection of 0.15 unit/kg body weight. Plasma glucose reached nadir values of 2.08 +/- 0.10, 1.82 +/- 0.21, 1.24 +/- 0.08 and 0.92 +/- 0.06 mmol/l (means +/- SEM) in the four experiments. Non-esterified fatty acid levels fell equally in all experiments but recovery was more rapid with severe hypoglycaemia. In contrast the rate of recovery of plasma glucose was slower with deeper hypoglycaemia and this appeared unrelated to the counter-regulatory response. Plasma glucagon, adrenaline and prolactin levels increased in proportion to the severity of hypoglycaemia, but peak concentrations of cortisol, growth hormone (somatotropin) and noradrenaline did not vary, suggesting that moderate hypoglycaemia had elicited maximal responses. When the areas under the curves were calculated, the cortisol responses were greater for the 6 units infusion and bolus injection than for the other infusions, and the growth hormone responses were similar for all three infusions but significantly greater with the bolus injection. Increases in heart rate and systolic blood pressure were related to the severity of hypoglycaemia, but changes in diastolic blood pressure and peripheral vascular resistance (assessed from calf and from hand blood flow) were not. Central temperature fell by 0.13 +/- 0.06 degrees C, 0.30 +/- 0.10 degrees C, 0.65 +/- 0.14 degrees C and 1.15 +/- 0.30 degrees C (means +/- SEM) in the four experiments, and the fall in skin temperature had a similar gradation. Many physiological responses to hypoglycaemia are not 'all-or-none', but vary according to the intensity of stimulus; some are already maximal at mild degrees of hypoglycaemia. Other changes are more complex, reflecting an interplay between opposing endocrine and neural responses.

Diminished immunoreactive gastric inhibitory polypeptide response to a meal in newly diagnosed type I (insulin-dependent) diabetics

The release of immunoreactive gastric inhibitory polypeptide (IR-GIP) in response to a standard meal was examined in 10 normal subjects and 15 type I (insulin-dependent) diabetics 7 days (test I), 14 days (test II), and 3 months (test III) after time of diagnosis. During all three tests, the diabetics had significantly lower plasma IR-GIP concentrations than the controls from 15-90 min after the standard meal. The IR-GIP response in the diabetics measured as the integrated area under the response curve corresponded to 70% of that of normal subjects. beta-cell function evaluated from the C-peptide response to the meal increased significantly from test I to test III whereas the IR-GIP response was similar during all three tests. As GIP is known to potentiate glucose-induced insulin secretion and possibly the biosynthesis of insulin, the low IR-GIP responses in subjects with type I diabetes may significantly influence insulin levels and hyperglycemia.

Molecular heterogeneity of glucagon in normal subjects and in patients with glucagon-producing tumours

The gel filtration profiles of immunoreactive glucagon as measured by region-specific radioimmunoassays were studied in plasma samples from eight patients with glucagon-producing tumours and in extracts from five of these tumours, and compared with profiles in plasma samples from 24 normal subjects, and pancreas extracts from four patients without pancreatic tumours. In all extracts a component corresponding in size to the glucagon marker constituted the majority of the immunoreactivity, but small amounts of larger components were found in normal subjects as well as tumour patients. Plasma samples from both groups contained glucagon-sized as well as larger components with elution position corresponding to approximately 8,000 daltons. However, it was impossible to localize the source (pancreatic versus extra-pancreatic) of the latter forms. Thus gel filtration profiles do not distinguish patients with glucagonomas from normal, and are of no greater value than simple radioimmunological plasma concentration determination.

Effect of vagus, gastric inhibitory polypeptide, and HCl on gastrin and somatostatin release from perfused pig antrum

The porcine antrum was isolated with the pancreas and perfused in vitro with an artificial medium supplemented with erythrocytes. The vagal innervation was preserved. Effluent was collected from the portal vein as well as from a vein directly draining the antrum. Electrical vagal stimulation increased gastrin output and inhibited somatostatin output. Intraluminal hydrochloric acid had the opposite effect. Gastric inhibitory polypeptide (GIP) in physiological concentrations (90 and 450 pmol/l) increased somatostatin output, inhibited gastrin output, and potentiated the effect of HCl on somatostatin release. Vagal stimulation, however, abolished the GIP effect on somatostatin output. Thus gastrin and somatostatin outputs were always inversely affected by the applied stimuli, suggestive of somatostatin-mediated control of gastrin secretion. GIP may exert its effects via local somatostatin release.

Somatostatin 1-28 circulates in human plasma

The gel filtration profile of immunoreactive somatostatin in human plasma in the fasting state is not well established as a consequence of insufficient sensitivity of the combined chromatography and radioimmunoassay procedures usually employed. We here report the gel filtration profiles of plasma samples after somatostatin concentration by batchwise immunoaffinity chromatography. The results clearly and reliably document the presence of a circulating peptide in human plasma with a gel permeation chromatography profile identical to the one of synthetic somatostatin 1-28. Approximately 46% of the total somatostatin-like immunoreactivity in plasma is due to this component.

Content and gel filtration profiles of glucagon-like and somatostatin-like immunoreactivity in human fundic mucosa

Biopsies from the fundic gastric mucosa of eight human subjects were extracted with acid-ethanol and analyzed for somatostatin- and glucagon-like immunoreactivity using region-specific RIAs. Five extracts were studied by gel filtration. The glucagon content was close to the detection limit in all extracts, and none of the known glucagon components could be identified by gel filtration. The concentration of somatostatin-like immunoreactivity was 17.4 +/- 2.0 pmol/g wet wt, and the immunoreactivity was distributed among four well defined peaks, two of which corresponded to somatostatin 1-14 and 1-28, respectively.

Stripping of endogenous ligands from antisera against glucagon

In some antisera raised against glucagon in rabbits a large fraction of the antibody binding sites are occupied by glucagon-like material which appears to be of endogenous origin. Six rabbits were immunized with a glucagon-albumin conjugate, boosted twice and bled 5 times during the course of 72 days. The antisera were found to contain between 110-750 nmol/l antibody-bound glucagon. The concentration of bound glucagon as well as the concentration of free antibody binding sites (titre) increased with time in 5 rabbits. By gel chromatography the bound material co-eluted with intact pancreatic glucagon (as opposed to the immunogen). Five different methods were examined for their ability to remove the ligand. Charcoal treatment of the antiserum at pH 2.5 for 48 h removed 91 +/- 5% of the bound ligand. After stripping, binding capacities (titres) and binding affinity (equilibrium constants) amounted to 63.2 +/- 19.4% and 105.0 +/- 25.4% of the respective pre-stripping values.

Role of the kidneys in elimination of glucagon, insulin, secretin and somatostatin in the rat

Immunoreactive plasma glucagon and secretin in the rat was elevated 48 hours after nephrectomy and ureteral ligation. Since kidneys obstructed by ureteral ligation were unable to remove glucagon and secretin from the blood, renal handling of glucagon and secretin must include glomerular filtration. Insulin and somatostatin levels were significantly elevated 48 hours after nephrectomy, but not after ureteral ligation, indicating partial uptake from peritubular capillaries.

Diurnal profile of pancreatic polypeptide, pancreatic glucagon, gut glucagon and insulin in human morbid obesity

The diurnal profiles of pancreatic glucagon, insulin, pancreatic polypeptide (PP), and enteroglucagon were studied in five obese non-diabetic subjects (195 +/- 11 per cent of ideal body weight) and in six age matched controls. All the subjects were served with ordinary mixed meals five times during the day. The obese subjects were normoglycemic but hyperinsulinemic. Both groups showed rapid increases in PP to all meals, but the PP-response was significantly impaired in the obese group during the first part of the day. Normal subjects showed significant enteroglucagon responses to all meals, and had elevated levels throughout the day. In obese subjects, levels and responses were much lower at all times. Pancreatic glucagon profiles were similar. It is concluded that the possible role of abnormalities of PP and enteroglucagon secretion in the pathogenesis of human obesity deserves further study.

Gut and pancreatic hormones after jejunoileal bypass with 3:1 or 1:3 jejunoileal ratio

The aim of the study was to elucidate the differential role of the jejunum and ileum in the regulation of secretion of the gut hormones, gastrin, gastric inhibitory polypeptide, and enteroglucagon, and the pancreatic hormones, insulin, glucagon, and pancreatic polypeptide, in man. We measured the plasma levels of the hormones (and glucose) during fasting and after a test meal in 34 obese patients, of whom 5 were waiting for bypass surgery and 29 had had a jejunoileal bypass with a 3:1 or 1:3 jejunoileal ratio between the functioning segments 3, 9, or 15 months earlier. The major findings were that surgery bypass (1) has no important influence on the levels of gastrin and pancreatic polypeptide, (2) reduces the level of gastric inhibitory polypeptide, insulin (and glucose), and enhances the pancreatic glucagon level, independently of the jejunoileal ratio, and (3) increases enteroglucagon secretion, most effectively so with a short jejunal and long ileal segment left in continuity. These findings suggest that the upper jejunum and terminal ileum has no important role in regulation of secretion of these hormones apart from that in secretion in enteroglucagon which is related to the length of functioning ileum.

Evidence that enteroglucagon (II) is identical with the C-terminal sequence (residues 33-69) of glicentin

Enteroglucagon (II) was isolated from extracts of pig ileum mucosa by repeated gel filtrations, and its immunochemical and chromatographic characteristics were compared with those of a synthetic peptide corresponding to the 33-69 sequence of pig glicentin, before and after digestion with trypsin or trypsin followed by carboxypeptidase B, by using five region-specific assays covering most of the glicentin sequence. Enteroglucagon (II) and the synthetic peptide behave identically under three different conditions of chromatography as determined with all five assays (including a highly specific radioreceptor assay), and gave rise to similar fragments after enzyme digestion. It was therefore concluded that enteroglucagon (II) and the 33-69 sequence of glicentin are most probably identical.

Vagal control of glucagon-induced inhibition of gastric acid secretion in duodenal ulcer patients

To study the vagal influence on the inhibitory effect of pancreatic glucagon on gastric acid secretion, the effect of exogenous pancreatic glucagon on pentagastrin-stimulated acid secretion was studied in duodenal ulcer patients before and after parietal cell vagotomy without drainage (PCV). Preoperatively, exogenous pancreatic glucagon inhibited gastric acid secretion, whereas no effect was found postoperatively. Plasma pancreatic glucagon was identical pre- and post-operatively and was within the physiological range. The study demonstrates that the inhibitory effect of pancreatic glucagon on pentagastrin-stimulated gastric acid secretion is dependent on an intact vagal innervation of the parietal cell area.

Interaction of glucagon and pentagastrin on pepsin secretion in healthy subjects

The effect of pentagastrin in step-wise increasing doses of 0 . 02, 2 . 0 and 20 nmol/kg/h (0 . 01, 1 . 0, and 10 . 0 micrograms/kg/h) on pepsin and acid secretion was studied in seven healthy subjects. The study was repeated on another day during infusion of glucagon in a dose of 103 pmol/kg/h (0 . 36 micrograms/kg/h) which results in plasma-glucagon concentrations comparable with those seen after a protein-rich meal. Pepsin output was maximal after 0 . 2 nmol/kg/h (0 . 1 microgram/kg/h) of pentagastrin and 20 nmol/kg/h (10 micrograms/kg/h) resulted in a marked decrease. The dose of pentagastrin required for half-maximal pepsin output was less than 0 . 1 nmol/kg/h (0 . 05 micrograms/kg/h). When the study was repeated during infusion of glucagon, the dose-response curve was shifted to the right. The highest pepsin output was obtained with 20 nmol/kg/h (10 micrograms/kg/h) of pentagastrin and D50 increased to well over 1 microgram/kg/h. The dose of pentagastrin required for half-maximal acid secretion was about 0 . 3 nmol/kg/h (0 . 15 micrograms/kg/h) indicating that the sensitivity of the chief cells to pentagastrin is more than three times that of the parietal cells.

The correlation between gastric emptying time and the response of GIP and enteroglucagon to oral glucose in duodenal ulcer patients

Simultaneous 50-g oral glucose tolerance tests and measurements of gastric emptying time were performed in 11 duodenal ulcer patients. Gastric emptying time, measured by the gamma-camera technique, and the response of gastric inhibitory polypeptide (GIP) and enteroglucagon to the oral load showed a significant negative correlation. The GIP response and the insulinogenic index were significantly positively correlated. It is concluded that the increased GIP and insulin response to glucose among duodenal ulcer patients may be explained by increased gastric emptying, known to occur in these patients. The study has not given new information on the possible physiological role of enteroglucagon.

On the accuracy of radioimmunological determination of somatostatin in plasma

We performed the following experiments to evaluate the accuracy of our newly developed radioimmunoassay for somatostatin: (1) Recovery of synthetic somatostatin added to human, porcine, and canine plasma with or without extraction with 67% acetone or 76% ethanol, using 3 different region-specific antibodies and, where applicable, 125I-labelled Tyr-1- or Tyr-11-substituted somatostatin or 125I-N-Tyr-somatostatin as tracers. The recovery of somatostatin corrected for losses inherent in the extraction procedure was close to 100%, and independent of species, antibody and tracer. Somatostatin 1-28 was extracted slightly less efficiently. Unextracted plasma interfered massively in the assay. (2) Pharmacokinetic experiments with infusion of somatostatin into 14 pigs and determination of metabolic clearance rate (MCR) and T-1/2. MCR was 27-38 ml/kg per min, independent of infusion rate (6.1 or 13 pmol/kg per min), extraction procedure or tracer. T-1/2 was 1.9 min. The infused somatostatin was not measurable in unextracted plasma. (3) Characterization of endogenous and exogenous, labelled and unlabelled somatostatin 1-14 in human plasma, using Sephadex G-50 columns at pH 7.5 and 9.0. Human plasma showed excess immunoreactivity eluting at the void volume whereas synthetic somatostatin was recovered quantitatively at the position of marker somatostatin when added to the plasma. The immunoreactivity of the tracers was decreased (125I-Tyr-11-somatostatin) or abolished (125I-N-Tyr- or 125I-Tyr-1-somatostatin) after incubation with plasma or void volume fractions of plasma subjected to gel filtration. Extracted plasma did not contain void volume immunoreactivity, but like whole plasma, small amounts of components which coeluted with intact somatostatin.

Effect of acute selective beta-1-adrenoceptor blockade on hormonal and cardiovascular response to insulin-induced hypoglycaemia in insulin-dependent diabetic patients

The hormonal and cardiovascular responses to intravenous (i.v.) insulin were studied in 16 insulin-dependent normotensive diabetic patients after acute injection of selective beta-1-adrenoceptor blocking agents. The lowest blood glucose levels were not affected by beta-1-adrenoceptor blockade while the time for reaching nadir was significantly reduced. Plasma adrenaline levels increased significantly during selective beta-1-adrenoceptor blockade. Plasma noradrenaline, glucagon and human growth hormone levels, however, remained unaffected. The insulin-induced tachycardia was not prevented by the beta-1-blockade, and the mean arterial blood pressure was unchanged. The ability to recognize the symptoms of insulin-induced hypoglycaemia persisted in all patients, although less pronounced in nine of them. We suggest that selective beta-1-adrenergic blocking agents may be employed without risk in the treatment of hypertensive insulin-dependent diabetic patients.

The molecular nature of vascularly released cholecystokinin from the isolated perfused porcine duodenum

Using sequence-specific radioimmunoassays, the quantities and molecular nature of cholecystokinin (CCK) have been determined in extracts of porcine duodenal mucosa and in the vascular perfusate from the isolated porcine duodenum. The basal concentration of CCK in the perfusate was 84 pM equiv. CCK-8 (mean; range: 32-173 pM, n = 5). After intraluminal stimulation with amino acids, acidified fat emulsions and hydrochloric acid, the concentrations increased 2--5-fold. Both in the basal and stimulated state the concentrations of the related hormone, gastrin, were below 5 pM equiv. gastrin-17. CCK in the perfusate was concentrated by affinity-chromatography using antibodies directed against the bioactive C-terminus. Subsequent gel chromatography revealed a form with a size like or slightly larger than the C-terminal dodecapeptide (CCK-12), a predominant form resembling the C-terminal octapeptide (CCK-8), and a form resembling the C terminal tetrapeptide (CCK-4). The duodenal mucosa contained in addition CCK-33, -39 and CCK-peptides with further N-terminal extensions. The results suggest that small CCK peptides are the principal circulating forms, while CCK-33 and larger forms are biosynthetic precursors.

Heterogeneity of somatostatin like immunoreactivity (SLI) in extracts of porcine, canine and human pancreas

Four different extraction procedure representative of methods commonly employed in the isolation of somatostatin like immunoreactivity (SLI) were tested for their ability to extract large MW forms of SLI from porcine, canine and human pancreas. The yield of SLI and recovery of added somatostatin was much higher with methods involving traditional acid/ethanol extraction (methods I and II) than with methods involving boiling of tissues in water or 2 M CH3COOH (methods III and IV). Porcine and canine pancreas extracted by methods III and IV (but not methods I and II) revealed remarkable molecular heterogeneity upon gel filtration, but immuno-affinity-chromatography eliminated the largest forms. A component of approximately 3000 daltons was immunoabsorbable and resisted refiltration in 8 M urea. No large forms were detectable in human pancreas. The SLI peaks eluting at the position of synthetic somatostatin could be resolved into two components, one of which was lacking C-terminal immunoreactivity. It is concluded that the method of extraction as well as the species investigated and the specificity of the antisera employed will influence significantly the results of studies of the tissue forms of somatostatin.

Nervous control of pancreatic endocrine secretion in pigs. V. Influence of the sympathetic nervous system on the pancreatic secretion of insulin and glucagon, and on the insulin and glucagon response to vagal stimulation

Electrical stimulation of the splanchnic nerves in anesthetized pigs was found to stimulate markedly the pancreatic secretion of glucagon. The response pattern was glucose dependent, the glucagon responses at blood glucose concentrations below 4.5 mmol x l-1 being significantly greater than those noted during stimulation at higher concentrations. Insulin secretion was stimulated weakly and variably and only at higher glucose levels. The magnitude of the glucagon response was comparable to that obtained by electrical stimulation of the thoracic vagus nerves with the same frequency. The glucagon response to combined vagal and splanchnic stimulation was nearly identical to the sum of the responses to the two types of stimulation, whereas splanchnic stimulation abolished or reduced the increase in insulin secretion elicited by vagal stimulation. Combined alpha- and beta-adrenergic blockade markedly reduced the glucagon responses to splanchnic stimulation.

Nervous control of pancreatic endocrine secretion in pigs. IV. The effect of somatostatin on the insulin and glucagon responses to electrical vagal stimulation and to intraarterial acetylcholine

We studied the effect of a primed i.v. infusion of somatostatin (0.5 microgram x min-1 x kg-1) on the glucose dependent insulin and glucagon responses to electrical stimulation of the vagus nerves or to i.a. acetylcholine in anesthetized pigs. Somatostatin completely abolished the insulin and glucagon responses to ongoing vagal stimulation; after 70 min somatostatin infusion the response to reiterated stimulation was profoundly inhibited. After termination of the somatostatin infusion, a considerable rebound secretion of insulin and glucagon was noted. By contrast, the endocrine response to acetylcholine persisted in spite of the somatostatin administration. Blood glucose increased slightly during somatostatin infusion. The results suggest that somatostatin inhibits the responses to vagal stimulation by interference with the neural transmission to the pancreatic islets rather than by inhibition of the islet cells themselves; acetylcholine may be involved in this neural transmission (acting on nicotinic receptors).

Secretin release from the isolated, vascularly perfused pig duodenum

1. A method for the isolation and vascular perfusion of the porcine pancreas and duodenum was developed. 2. The oxygen consumption of the whole preparation was similar to that of the pancreas alone, and since the duodenal arteriovenous oxygen deficit was similar to that of the total preparation, it was concluded that the duodenum respired adequately. 3. The duodenum rapidly absorbed luminally administered radioactive glucose, and this absorption was strongly inhibited by ouabain and phloridzin. 4. The duodenum secreted secretin rapidly in response to hydrochloric acid, but did not respond to any other luminal stimuli, including lipids, proteins, carbohydrates and bile. Neither was secretin release stimulated by intra-arterially injected acetylcholine. 5. By gel permeation chromatography the release immunoreactive secretin behaved identically to pure natural secretin, indicating that the tissue form and the circulating form have identical molecular size. 6. It is concluded that this model offers an unique opportunity to study the endocrine secretion of the duodenum.

Effect of highly purified porcine gut glucagon-like immunoreactivity (glicentin) on glucose release from isolated rat hepatocytes

We studied the effect of the highly purified gut peptide glicentin on the glucose production and cyclic AMP accumulation of isolated rat hepatocytes. Glicentin at 2.10(-7) mol/l had the same effect on glucose production as maximally effective concentrations of glucagon, but did not stimulate cyclic AMP to the same extent; furthermore, glicentin apparently had only 1/100 of the potency of glucagon on glucose production. During incubation with hepatocytes glicentin was degraded to low molecular weight fragments one of which were chromatographically very similar to fragments of glucagon. It is suggested that glicentin exerts its glucagon-like effects on hepatocytes only after degradation to glucagon-like fragments. The results also demonstrate that the coupling between cyclic AMP accumulation and glucose production depends on the nature of the stimulatory peptide.

Significance of glucagon for insulin secretion and hepatic glycogenolysis during exercise in rats

The significance of glucagon and of the sympatho-adrenal system for insulin secretion and hepatic glycogen depletion during exercise was studied. Male rats were either adrenodemedullated and chemically sympathectomized with 6-hydroxydopamine (SX) or sham-treated (C). During light ether anesthesia, cardiac blood for glucose analysis and a biopsy of the liver were obtained, and either antigen-stripped glucagon antibodies (A) or control gamma globulins (N) in saline were injected through the cardiac cannula. Subsequently, the rats swam in tepid water (33-34 degree C) for 100 minutes with a tail weight attached (2% of body weight). Then cardiac blood was drawn for analysis of glucose, insulin and glucagon, and a sample of the liver was collected. In both CA and CN rats, the blood glucose concentration tended to increase (p less than 0.1) during exercise, whereas hepatic glycogen depletion and the plasma insulin concentration were lower in CA rats compared to CN rats. In SX rats, the blood glucose concentration did not increase during exercise, and in SXA but not in SXN rats, the hepatic glucogen depletion was lower than in CN rats. The plasma insulin concentration was consistently higher in SX rats than in C rats, and was significantly decreased by glucagon antibodies in SX as well as in C rats. In conclusion, in exercising rats, glucagon enhances hepatic glycogen depletion. Furthermore, glucagon and the sympatho-adrenal system increase and decrease, respectively, the plasma insulin concentration.

Effect of endogenous pancreatic glucagon on gastric acid secretion in patients with duodenal ulcer before and after parietal cell vagotomy

The effect of endogenous pancreatic glucagon on submaximal pentagastrin stimulated gastric acid secretion was studied by infusion of 1-arginine in patients with duodenal ulcer before and after parietal cell vagotomy without drainage (PCV). Preoperatively infusion of 1-arginine resulted in a marked inhibition of acid secretion, whereas no effect was found postoperatively. Plasma glucagon concentrations were identical pre- and postoperatively, fasting as well as during arginine infusion. Serum gastrin concentration rose after PCV but not unaffected by arginine infusion both pre- and postoperatively. The study demonstrates that intact vagal innervation of the fundic glands is a condition of inhibition of pentagastrin induced acid secretion by pancreatic glucagon released by infusion of 1-arginine.

Depression of insulin release by anti-GIP serum after oral glucose in rats

An oral glucose tolerance test (OGTT), an OGTT after infusion of anti-gastric inhibitory polypeptide (GIP) serum, and an intravenous glucose infusion were performed in unrestrained and unanesthetized rats. In the rats treated with anti-GIP serum the insulin release was significantly depressed. This finding supports the concept that GIP is a physiologically important 'glucose-dependent insulin-releasing peptide'.

Secretory effects of cholecystokinins on the isolated perfused porcine pancreas

Three different molecular forms of cholecystokinin (CCK-39, -33, and -8) were used in concentrations from 10(-11) to 19(-8) mol/l to stimulate the endocrine and exocrine secretion from the isolated perfused porcine pancreas. During perfusion with a glucose concentration of 7.5 mmol/l CCK-39 in the highest concentration increased the insulin secretion slightly. No significant effect was observed at lower glucose concentrations (5.0 and 3.5 mmol/l). CCK-33 and -8 did not stimulate the secretion of insulin significantly, and neither of the cholecystokinins increased the secretion of glucagon and bicarbonate. All three molecular forms stimulated the secretion of fluid and protein in concentrations above 10(-11) mol/l in a dose-dependent manner and with equal potency. We conclude that the effect of these three cholecystokinins on the endocrine pancreas is without physiological significance, whereas all three are sufficiently potent to play a role in the control of pancreatic protein secretion.

Secretory effects of gastric inhibitory polypeptide on the isolated perfused porcine pancreas

The effect of gastric inhibitory polypeptide (GIP) in physiological concentrations (250, 500, 1,000 and 2,000 pg/ml) upon endocrine and exocrine secretion from the isolated perfused porcine pancreas was studied at various glucose concentrations in the perfusate. GIP increased insulin release in a dose-dependent manner. The sensitivity of the beta-cells to GIP was glucose independent. No effect was observed on glucagon or exocrine secretion regardless of the glucose concentration in the perfusate. We conclude that GIP is powerful insulin-stimulator even in low physiological concentrations in the presence of glucose concentrations comparable to those seen during an oral glucose load, which makes GIP to one of the strongest incretin candidates known, i.e. the factor(s) contributing to the augmented insulin response after ingestion of glucose.