Debas H T, Grossman M I
Gastroenterology. 1975 Sep;69(3):654-9.
Release of gastrin is the only recognized mechanism by which chemicals in the stomach stimulate acid secretion. We report here that dietary components coming in contact only with oxyntic gland mucosa stimulate near maximal acid secretion through a local, H-sensitive mechanism that does not involve gastrin. In 4 dogs with gastric fistula and Heidenhain pouch (HP), 10% liver extract, 10% peptone, 0.4 M glycine, or Tris buffer, as control, was instilled into the HP in volumes of 40, 80, or 160 ml every 30 min. Instilled solutions were adjusted to pH 8.0 and HP acid secretion was measured by titrating a sample of the fluid recovered from the HP back to pH 8.0 with 0.2 M NaOH. Instillation of liver extract into the HP stimulated acid secretion from the HP but caused no change in serum gastrin and no change in acid secretion from the gastric fistula. The maximal response to liver extract occurred with the largest volume instilled and was 80% of the maximal response to histamine and 188% of the maximal response to pentagastrin. Expressed as per cent of maximal response to histamine, the maximal response to Tris buffer was 8%, to peptone 44%, and to glycine 14%. Intact bovine serum albumin gave no response, but after digestion by pepsin it stimulated acid secretion moderately. At pH 2.0, liver extract caused no stimulation of acid secretion. The pH threshold was about 2.5, and at pH 4.5 acid secretion was 55% of the response at pH 8.0. The response to liver extract at pH 8.0 was only minimally decreased by topical lidocaine or by intravenous atropine or metiamide. Since atropine and metiamide almost totally abolish the acid response to food in the main stomach, but do not inhibit secretion of acid evoked by instilling liver extract into the HP, there is reason to doubt whether this new mechanism operates under physiological conditions.
胃泌素的释放是胃内化学物质刺激胃酸分泌的唯一公认机制。我们在此报告,仅与泌酸腺黏膜接触的饮食成分通过一种不涉及胃泌素的局部H敏感机制刺激近乎最大程度的胃酸分泌。在4只具有胃瘘和海登海因袋(HP)的狗中,每30分钟将10%肝提取物、10%蛋白胨、0.4M甘氨酸或作为对照的Tris缓冲液以40、80或160ml的体积注入HP。将注入的溶液调节至pH 8.0,并用0.2M NaOH将从HP回收的液体样品滴定回pH 8.0来测量HP的胃酸分泌。将肝提取物注入HP刺激了HP的胃酸分泌,但血清胃泌素无变化,胃瘘的胃酸分泌也无变化。对肝提取物的最大反应出现在注入最大体积时,为对组胺最大反应的80%,对五肽胃泌素最大反应的188%。以对组胺最大反应的百分比表示,对Tris缓冲液的最大反应为8%,对蛋白胨为44%,对甘氨酸为14%。完整的牛血清白蛋白无反应,但经胃蛋白酶消化后可适度刺激胃酸分泌。在pH 2.0时,肝提取物不刺激胃酸分泌。pH阈值约为2.5,在pH 4.5时胃酸分泌为pH 8.0时反应的55%。在pH 8.0时,局部利多卡因、静脉注射阿托品或甲硫咪胺仅使对肝提取物的反应略有降低。由于阿托品和甲硫咪胺几乎完全消除了主胃对食物的胃酸反应,但不抑制将肝提取物注入HP所诱发的胃酸分泌,因此有理由怀疑这种新机制是否在生理条件下起作用。