Adler G, Reinshagen M, Koop I, Göke B, Schafmayer A, Rovati L C, Arnold R
Department of Internal Medicine, University of Marburg, Federal Republic of Germany.
Gastroenterology. 1989 Apr;96(4):1158-64. doi: 10.1016/0016-5085(89)91636-3.
The present study evaluates the effect of atropine and of the cholecystokinin receptor antagonist loxiglumide on feedback regulation of basal pancreatic secretion in 6 healthy volunteers. The intraduodenal instillation of the protease inhibitor camostate reduced enzymatic activities of trypsin and chymotrypsin by 80%. This was accompanied by a strong increase in amylase and lipase output. The intravenous infusion of atropine (5 micrograms/kg.h) completely abolished the stimulatory effect of camostate on enzyme output. The infusion of loxiglumide (10 mg/kg.h) caused no changes in camostate-induced stimulation of enzyme output. Plasma levels of cholecystokinin were not altered after intraduodenal instillation of camostate whether atropine, loxiglumide, or saline were infused. We suggest that the protease inhibitor camostate, by inhibition of the enzymatic activity of trypsin and chymotrypsin, interferes with feedback regulation of basal pancreatic secretion in humans, and this mechanism is predominantly mediated by the cholinergic system.
本研究评估了阿托品及胆囊收缩素受体拮抗剂洛西溴铵对6名健康志愿者基础胰腺分泌反馈调节的影响。十二指肠内滴注蛋白酶抑制剂卡莫司他可使胰蛋白酶和糜蛋白酶的酶活性降低80%。与此同时，淀粉酶和脂肪酶的分泌量大幅增加。静脉输注阿托品（5微克/千克·小时）可完全消除卡莫司他对酶分泌的刺激作用。输注洛西溴铵（10毫克/千克·小时）对卡莫司他诱导的酶分泌刺激无影响。十二指肠内滴注卡莫司他后，无论输注阿托品、洛西溴铵还是生理盐水，血浆胆囊收缩素水平均未改变。我们认为，蛋白酶抑制剂卡莫司他通过抑制胰蛋白酶和糜蛋白酶的酶活性，干扰了人类基础胰腺分泌的反馈调节，且该机制主要由胆碱能系统介导。
