Mochiki E, Suzuki H, Takenoshita S, Nagamachi Y, Kuwano H, Mizumoto A, Itoh Z
First Department of Surgery, School of Medicine, Institute for Molecular and Cellular Regulation, Gunma University, Maebashi, Japan.
J Gastroenterol. 1998 Dec;33(6):835-41. doi: 10.1007/s005350050184.
Glucagon is commonly used during gastrointestinal examinations for the temporary inhibition of gastroduodenal movements. Three preparations of glucagon are now clinically available: those prepared by extraction from the pancreas (GL-P), by chemical synthesis (GL-S), and by genetic recombination (GL-G). The aim of this study was examine the mechanism of the inhibitory effect of glucagon on gastrointestinal motility and the cause of its side effects by comparing three glucagon preparations. In four conscious dogs, gastrointestinal contractions were monitored by means of chronically implanted force transducers. Each glucagon preparation (GL-P [15 microg/kg], GL-S [5, 15, 45 microg/kg], GL-G [15 microg/kg]), scopolamine butylbromide (0.4 mg/ kg), or saline was administered intravenously 20 min after the termination of spontaneous phase III contractions, and blood samples were taken at 5- to 10-min intervals. Barium was administered into the stomach 10 min after the infusion of each drug. The arrival of a barium meal in the stomach immediately stimulated gastrointestinal contractions, and the barium meal was expelled into the duodenum and jejunum from the stomach. Intravenous injection of 15 microg GL-S first stimulated duodenal contractions that propagated to the jejunum, followed by strong inhibition of the barium-induced gastrointestinal contractions. This inhibitory effect of glucagon and the activity of the glucagon-induced duodenal contractions were dose-related. The inhibitory effects of GL-G and GL-S were stronger than that of GL-P. Blood glucose and plasma insulin concentrations were raised after intravenous injection of each glucagon preparation, but there was no difference among the three preparations and no dose relationship. The inhibitory effects of glucagon depend on the material purity and dose, and the inhibitory mechanism was independent of any effect on carbohydrate metabolism. Glucagon administration caused phase III-like contractions in the duodenum and jejunum, which may be responsible for the side effects of glucagon.
胰高血糖素在胃肠道检查中常用于暂时抑制胃十二指肠运动。目前临床上有三种胰高血糖素制剂:从胰腺提取制备的(GL-P)、化学合成的(GL-S)和基因重组的(GL-G)。本研究的目的是通过比较三种胰高血糖素制剂来研究胰高血糖素对胃肠动力抑制作用的机制及其副作用的原因。在四只清醒犬中,通过长期植入的力传感器监测胃肠收缩。在自发的III期收缩终止后20分钟静脉注射每种胰高血糖素制剂(GL-P [15微克/千克]、GL-S [5、15、45微克/千克]、GL-G [15微克/千克])、丁溴东莨菪碱(0.4毫克/千克)或生理盐水,并每隔5至10分钟采集血样。在输注每种药物10分钟后将钡剂注入胃内。钡餐进入胃内立即刺激胃肠收缩,钡餐从胃内排入十二指肠和空肠。静脉注射15微克GL-S首先刺激十二指肠收缩并传播至空肠,随后强烈抑制钡剂诱导的胃肠收缩。胰高血糖素的这种抑制作用以及胰高血糖素诱导的十二指肠收缩活性与剂量相关。GL-G和GL-S的抑制作用强于GL-P。静脉注射每种胰高血糖素制剂后血糖和血浆胰岛素浓度升高,但三种制剂之间无差异且无剂量关系。胰高血糖素的抑制作用取决于物质纯度和剂量,其抑制机制与对碳水化合物代谢的任何影响无关。给予胰高血糖素会在十二指肠和空肠引起类似III期的收缩,这可能是胰高血糖素副作用的原因。