Imamura M, Hattori Y, Nishida O, Honda T, Shimada Y, Miyahara T, Wagata T, Baba N, Tobe T
Department of Surgery 1, Faculty of Medicine, Kyoto University, Japan.
Pancreas. 1990 Jul;5(4):467-73. doi: 10.1097/00006676-199007000-00015.
It is well known that B cells in the pancreas release insulin when stimulated by secretin, but there have been few reports on the response of insulinoma cells to secretin. In five patients with insulinoma, changes in serum immunoreactive insulin (IRI) concentration were measured after the intravenous injection of secretin into the peripheral vein before and after extirpation of the insulinoma. The extirpated insulinomas were cultured and tested for their response to secretin. The rise in serum IRI in response to secretin in patients with insulinoma was significantly slower and smaller than in normal volunteers. After removal of the insulinoma, the response to secretin became prompt and increased with time. Cultured insulinoma cells did not release insulin when stimulated by secretin. Therefore, it is concluded that the response of insulinoma cells to secretin is quite different from that of normal beta cells, and that the function of beta cells in the insulinoma-bearing pancreas is suppressed by the autonomous hypersecretion of insulin by the insulinoma. The extent of the decrease in function of the beta cells in patients with insulinoma can be estimated by the intravenous secretin test. Thus, the secretin test is sometimes useful in the differentiation of hypoglycemia due to insulinoma from that due to beta cell hyperplasia or alimentary hyperinsulinemia.
众所周知，胰腺中的B细胞在促胰液素刺激下会释放胰岛素，但关于胰岛素瘤细胞对促胰液素的反应的报道却很少。在5例胰岛素瘤患者中，在切除胰岛素瘤前后，经外周静脉静脉注射促胰液素后，测量血清免疫反应性胰岛素（IRI）浓度的变化。将切除的胰岛素瘤进行培养，并检测其对促胰液素的反应。胰岛素瘤患者对促胰液素反应时血清IRI的升高明显比正常志愿者缓慢且幅度小。切除胰岛素瘤后，对促胰液素的反应变得迅速，并随时间增加。培养的胰岛素瘤细胞在促胰液素刺激下不释放胰岛素。因此，得出结论，胰岛素瘤细胞对促胰液素的反应与正常β细胞的反应有很大不同，并且胰岛素瘤自主分泌过多胰岛素会抑制携带胰岛素瘤的胰腺中β细胞的功能。胰岛素瘤患者β细胞功能降低的程度可以通过静脉注射促胰液素试验来估计。因此，促胰液素试验有时有助于鉴别胰岛素瘤所致低血糖与β细胞增生或饮食性高胰岛素血症所致低血糖。
