Otsuki M, Williams J A
J Clin Invest. 1982 Jul;70(1):148-56. doi: 10.1172/jci110588.
The nature and mechanism of the pancreatic exocrine dysfunction in diabetes mellitus were evaluated in vitro using isolated pancreatic acini prepared from streptozotocin-induced diabetic rats. The content of amylase and ribonuclease in diabetic acini was approximately 0.5 and 50% of the normal content, respectively. Further, reduced amounts of both enzymes were secreted by diabetic acini in response to both cholecystokinin (CCK) and carbamylcholine. However, when enzyme secretion was normalized relative to initial acinar contents, both normal and diabetic acini released enzymes at a comparable maximal rate. The time course of the release of these enzymes, and newly synthesized protein were similar in both acini. In normal acini, the effect of CCK was maximal at a concentration of 100 pM; higher concentrations led to submaximal enzyme release. The dose-response curve in diabetic acini was similarly shaped, but shifted three-fold towards higher concentration. The mobilization of cellular Ca(2+) in response to CCK was also shifted. In contrast to these results with CCK, the dose-response curve to carbamylcholine was unaltered by diabetes. The observed effects were confirmed to be due to insulin deficiency and not due to direct toxic effect of streptozotocin on acinar cells or malnutrition. Streptozotocin had no acute effect on acini when measured 24 h after administration, and alloxan, another beta cell toxin, induced similar changes in acinar enzyme content and secretory response. Moreover, the administration of exogenous insulin to diabetic rats returned the content of pancreatic amylase and the secretory response to CCK towards normal. Starvation for 48 h, although inducing a significant weight loss, did not mimic the effects of diabetes. The present studies demonstrate two major abnormalities in pancreatic exocrine secretion in the diabetic rat: (a) the content of certain digestive enzymes is markedly altered, leading to an altered amount of zymogen secretion, (b) the sensitivity to CCK is selectively reduced, most likely related to a defect in receptor activated transmembrane signaling.
利用从链脲佐菌素诱导的糖尿病大鼠制备的离体胰腺腺泡,在体外评估了糖尿病中胰腺外分泌功能障碍的性质和机制。糖尿病腺泡中淀粉酶和核糖核酸酶的含量分别约为正常含量的0.5%和50%。此外,糖尿病腺泡对胆囊收缩素(CCK)和氨甲酰胆碱的反应分泌的这两种酶的量均减少。然而,当酶分泌相对于初始腺泡含量正常化时,正常和糖尿病腺泡均以相当的最大速率释放酶。这些酶以及新合成蛋白质的释放时间进程在两种腺泡中相似。在正常腺泡中,CCK浓度为100 pM时作用最大;更高浓度导致酶释放次最大。糖尿病腺泡中的剂量反应曲线形状相似,但向更高浓度方向移动了三倍。CCK刺激引起的细胞Ca(2+)动员也发生了改变。与CCK的这些结果相反,糖尿病对氨甲酰胆碱的剂量反应曲线没有改变。观察到的效应被证实是由于胰岛素缺乏,而不是由于链脲佐菌素对腺泡细胞的直接毒性作用或营养不良。给药24小时后测量,链脲佐菌素对腺泡没有急性作用,另一种β细胞毒素四氧嘧啶也诱导腺泡酶含量和分泌反应发生类似变化。此外,给糖尿病大鼠注射外源性胰岛素可使胰腺淀粉酶含量和对CCK的分泌反应恢复正常。饥饿48小时虽然导致体重显著减轻,但并未模拟糖尿病的效应。本研究证明糖尿病大鼠胰腺外分泌存在两个主要异常:(a)某些消化酶的含量明显改变,导致酶原分泌量改变;(b)对CCK的敏感性选择性降低,很可能与受体激活的跨膜信号转导缺陷有关。