Masclee A A, Gielkens H G, Ledeboer M L, van der Kleij F G, Jebbink M C, Lamers C B
Department of Gastroenterology-Hepatology, University Hospital Leiden, The Netherlands.
Regul Pept. 1995 Aug 22;58(3):157-61. doi: 10.1016/0167-0115(95)00064-i.
Erythromycin, a motilin agonist, enhances gastrointestinal motility but also stimulates endogenous pancreatic polypeptide (PP) secretion. We investigated whether the effect of erythromycin on PP release is dependent on (1) prokinetic activity of erythromycin generated from the antrum and (2) the long vagus nerve since erythromycin acts via cholinergic neurons. Erythromycin induced PP secretion was determined in 14 patients with antrectomy (6 patients with Billroth I type anastomosis, 8 patients with Billroth II type anastomosis), in 6 patients with truncal vagotomy and pyloroplasty but without gastric resection and in 8 healthy controls. Plasma PP levels in response to erythromycin (3 mg/kg i.v.) were determined at regular intervals for 180 min. Erythromycin induced a significant increase in plasma PP in the control subjects from 22 +/- 4 pmol/l (basal) to 49 +/- 4 pmol/l at 10 min. In the patients with truncal vagotomy plasma PP secretion after erythromycin was significantly (P < 0.05) increased (peak increment vs. basal: 98 +/- 10 pmol/l vs. 27 +/- 2 pmol/l) and prolonged compared to controls. In the patients with antrectomy no significant increases in plasma PP over basal were observed after erythromycin infusion. It is concluded that erythromycin stimulates PP secretion in healthy controls. The PP response to erythromycin is exaggerated after truncal vagotomy but absent after antrectomy indicating that the antrum is essential for erythromycin induced PP secretion.
红霉素作为一种胃动素激动剂，可增强胃肠动力，但也会刺激内源性胰多肽（PP）分泌。我们研究了红霉素对PP释放的影响是否依赖于：（1）胃窦产生的红霉素的促动力活性；（2）由于红霉素通过胆碱能神经元起作用，所以是否依赖于迷走神经。在14例胃窦切除术患者（6例毕罗Ⅰ式吻合术患者，8例毕罗Ⅱ式吻合术患者）、6例迷走神经切断术加幽门成形术但未行胃切除术的患者以及8例健康对照者中，测定了红霉素诱导的PP分泌。静脉注射红霉素（3mg/kg）后，每隔一定时间测定180分钟内血浆PP水平。在对照受试者中，红霉素使血浆PP从基础值22±4pmol/L显著升高至10分钟时的49±4pmol/L。与对照组相比，迷走神经切断术患者静脉注射红霉素后血浆PP分泌显著增加（P<0.05）（峰值增量与基础值相比：98±10pmol/L对27±2pmol/L）且持续时间延长。胃窦切除术患者静脉输注红霉素后，血浆PP较基础值无显著升高。结论是，红霉素在健康对照者中刺激PP分泌。迷走神经切断术后对红霉素的PP反应增强，但胃窦切除术后则无反应，这表明胃窦对于红霉素诱导的PP分泌至关重要。
