In vitro and in vivo effect of proglumide on cholecystokinin-stimulated amylase release in mouse pancreatic acini

Role of CCK-A receptor for pancreatic function in mice: a study in CCK-A receptor knockout mice

INTRODUCTION

The cholecystokinin (CCK) family of peptides and receptors is present throughout the brain and gastrointestinal tract. The CCK receptors can be pharmacologically subdivided into two subtypes: CCK-A and CCK-B. CCK-A receptor is enriched in the pancreas of mice.

AIMS

To determine pancreatic functions in a CCK-A receptor deficient mouse mutant generated by gene targeting in embryonic stem cells. The targeting vector contained lacZ and neo insertions in exon 2.

METHODOLOGY

To examine exocrine functions, amylase release from the dispersed acini in vitro was examined. In the in vivo study, the mixture of bile-pancreatic juice was collected, and amylase, bicarbonate, and bile acid outputs were determined after the administration of various stimulants. The cystic duct of the gallbladder and the pylorus were ligated to exclude the involvement of gallbladder contraction and gastric acid. Pancreatic enzyme content was measured, and histologic examinations by HE and lacZ staining were conducted. To examine endocrine functions, oral glucose tolerance test (2 g/kg) was determined.

RESULTS

The body weight, pancreatic wet weight, and enzyme content in the pancreas were similar among the three genotypes. Amylase release in vivo and in vitro and bicarbonate secretion in vivo were not stimulated by CCK-8 in CCK-AR (-/-) mice, whereas the responses to other stimulants were substantial in (-/-) mice. Administration of secretin did not increase bicarbonate secretion regardless of genotype. A normal glucose tolerance was observed in (-/-) mice. Acinar cells, islets, and duct cells were stained by lacZ, and HE staining revealed no pathologic findings.

CONCLUSION

The CCK-A receptor is important for pancreatic exocrine secretion, but not essential for maintaining glucose concentration and pancreatic growth in mice.

Effects of proglumide on pancreatic endocrine and exocrine function in healthy humans

A comparative study was done on the pancreatic endocrine (insulin (IRI), human pancreatic polypeptide (hPP] and exocrine secretion (fluid volume, amylase output, bicarbonate output), before and after administration of proglumide. At the time of the test meal loading, plasma hPP and cholecystokinin (CCK) were also measured. During continuous i.v. administration of proglumide 750 mg and 1650 mg/h 30 min before CCK-8 (20 ng/kg) stimulation, no significant difference in the rise of plasma hPP level was observed, as compared with a single stimulus of CCK-8, nor were there any significant differences in the exocrine secretion. The values of hPP and CCK-8 under a load of test meal significantly elevated after a food load. Although hPP showed a significant inhibition with the administration of proglumide 1650 mg/h, plasma CCK-8 and blood sugar levels were not significantly different from control groups. Therefore, while proglumide has a very weak effect on the action of pancreatic endocrine function, it does have an inhibitory effect on pancreatic function, during physiological stimulation.

Basal and stimulated human gastric bicarbonate secretion

The mucus-bicarbonate barrier on the gastric mucosa is regarded as a first-line of defence against acid. Both mucus and bicarbonate originate from the mucus cells in the gastric mucosa. Bicarbonate is secreted actively by Cl-/HCO3- exchange at the luminal cell membrane. A computer based system with continuous measurement of pH and PCO2 in a gastric perfusion system was used to determine human gastric bicarbonate secretion. The rate of basal gastric bicarbonate secretion in 24 healthy subjects was 386 +/- 31 mumol/h (mean +/- SEM). The 95% confidence interval for basal bicarbonate output was 103-669 mumol/h. Vagal stimulation by sham feeding increased the bicarbonate output by 63% and instillation of 16,16 dimethyl prostaglandin E2 increased the bicarbonate output by 214%. The response to vagal stimulation was independent of intragastric pH. The sham feeding response was abolished by premedication with anticholinergics. Basal and vagally stimulated bicarbonate secretion was unaffected by prostaglandin biosynthesis blockade.

Anal manometric findings in patients with anal incontinence

Anal manometric measurements were performed on 25 patients suffering from partial or total anal incontinence. Eleven patients were partially incontinent, and 14, totally incontinent. Compared with age- and sex-matched controls, both incontinent groups had significantly lower maximum basal pressure (MBP) and maximum squeeze pressure (MSP). Comparing the totally incontinent group with the partially incontinent group, the former had significantly lower MBP, but MSP did not differ significantly. The patients could also be grouped according to different manometric patterns, and it was shown that if both basal and squeeze pressures were low, the patients were prone to be totally incontinent. If only the voluntary function, MSP was low, the patients were most likely partially incontinent.