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胆碱能肠胰反射可能独立于胆囊收缩素释放的证据。

Evidence that the cholinergic enteropancreatic reflex may be independent of cholecystokinin release.

作者信息

Modlin I M, Hansky J, Singer M, Walsh J H

出版信息

Surgery. 1979 Aug;86(2):352-61.

PMID:111364
Abstract

Studies were performed in four dogs with chronic gastric and pancreatic fistulas following intraduodenal perfusion with 10 mmole hr-1 of sodium oleate for 30 minutes. Radioimmunoassay (RIA) of plasma CCK LI was undertaken by an RIA method using labeled, desulfated CCK 8 I125 and an antiserum raised to CCK 8. The detection limit for the assay was 0.25 to 0.5 fmole and the lowest detectable plasma level was 5 to 10 fmoles ml-1. Since there was equal cross-reactivity to gastrin, a gastrin-specific assay also was employed to evaluate any changes in gastrin levels. After oleate infusion the plasma CCK increment above basal was 50 +/- 11 fmoles ml-1, with return to basal levels after 60 minutes. Administration of atropine significantly (P less than 0.01) inhibited the release of CCK in the first 20 minutes. Thereafter CCK release was not reduced. Plasma gastrin values did not change before and after oleate perfusion. Pancreatic protein output increased from 72 +/- 12 to 420 +/- 55 mg/10 min-1 after oleate administration. However, after atropinization the rise in pancreatic protein output was significantly lower (152 +/- 36 mg/10 min-1) (P less than 0.01). We have shown that, using our RIA method, there is a measurable rise in plasma CCK LI after intraduodenal oleate. After atropinization the CCK response was decreased significantly during the first 30 minutes, but was virtually unchanged during the second 30 minutes, when the fall in pancreatic protein output was most marked. We conclude that the cholinergic mechanism which plays a role in the endogenous stimulation of pancreatic protein secretion by intraduodenal oleate cannot be explained simply be decreased CCK release. This mechanism may be hormonal, distinct from secretin, or neural possibly, via activation of an enteropancreatic reflex.

摘要

对4只患有慢性胃瘘和胰瘘的犬进行了研究,在十二指肠内以10毫摩尔/小时的速率灌注油酸钠30分钟。采用标记的去硫酸化CCK 8 I125和针对CCK 8产生的抗血清,通过放射免疫分析法(RIA)对血浆CCK样免疫活性(CCK LI)进行检测。该检测方法的检测限为0.25至0.5飞摩尔,最低可检测血浆水平为5至10飞摩尔/毫升。由于对胃泌素具有同等交叉反应性,因此还采用了胃泌素特异性检测方法来评估胃泌素水平的任何变化。油酸钠输注后,血浆CCK较基础值的增量为50±11飞摩尔/毫升,60分钟后恢复至基础水平。阿托品给药在最初20分钟内显著(P<0.01)抑制了CCK的释放。此后CCK释放未减少。油酸钠灌注前后血浆胃泌素值未发生变化。油酸钠给药后,胰腺蛋白质输出量从72±12增加至420±55毫克/10分钟。然而,阿托品化后胰腺蛋白质输出量的增加显著降低(152±36毫克/10分钟)(P<0.01)。我们已经表明,使用我们的RIA方法,十二指肠内注入油酸钠后血浆CCK LI有可测量的升高。阿托品化后,CCK反应在最初30分钟内显著降低,但在第二个30分钟内基本不变,此时胰腺蛋白质输出量的下降最为明显。我们得出结论,十二指肠内油酸钠对内源性胰腺蛋白质分泌的刺激作用中起作用的胆碱能机制不能简单地用CCK释放减少来解释。该机制可能是激素性的,与促胰液素不同,或者可能是神经性的,通过激活肠胰反射。

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引用本文的文献

1
Plasma cholecystokinin concentrations in patients with pancreatic insufficiency measured by sequence-specific radioimmunoassays.采用序列特异性放射免疫分析法测定胰腺功能不全患者的血浆胆囊收缩素浓度。
Dig Dis Sci. 1984 Dec;29(12):1109-17. doi: 10.1007/BF01317085.
2
Vagal control of gall-bladder contraction.迷走神经对胆囊收缩的控制。
J Physiol. 1984 Oct;355:65-70. doi: 10.1113/jphysiol.1984.sp015406.
3
Latency of pancreatic fluid secretory response to intestinal stimulants in the dog.犬对肠道刺激物的胰液分泌反应潜伏期
J Physiol. 1983 Jun;339:75-85. doi: 10.1113/jphysiol.1983.sp014703.
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5
Neural pathways for the release of gastrin, cholecystokinin, and pancreatic polypeptide after a meal in dogs. Role of gastric and splanchnic nerves.犬进食后胃泌素、胆囊收缩素和胰多肽释放的神经通路。胃神经和内脏神经的作用。
Dig Dis Sci. 1986 Dec;31(12):1361-9. doi: 10.1007/BF01299815.
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Impaired exocrine pancreatic function in diabetics with diarrhea and peripheral neuropathy.糖尿病合并腹泻和周围神经病变患者的胰腺外分泌功能受损。
Dig Dis Sci. 1988 Jun;33(6):705-10. doi: 10.1007/BF01540434.
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Gastroenterol Jpn. 1988 Jun;23(3):292-8. doi: 10.1007/BF02779473.