cholecystokinin and Duodenal-Diseases

Severe congenital diarrhea occurs in approximately half of patients with Aristaless-Related Homeobox (ARX) null mutations. The cause of this diarrhea is unknown. In a mouse model of intestinal Arx deficiency, the prevalence of a subset of enteroendocrine cells is altered, leading to diarrhea. Because polyalanine expansions within the ARX protein are the most common mutations found in ARX-related disorders, we sought to characterize the enteroendocrine population in human tissue of an ARX mutation and in a mouse model of the corresponding polyalanine expansion (Arx).. Immunohistochemistry and quantitative real-time polymerase chain reaction were the primary modalities used to characterize the enteroendocrine populations. Daily weights were determined for the growth curves, and Oil-Red-O staining on stool and tissue identified neutral fats.. An expansion of 7 alanines in the first polyalanine tract of both human ARX and mouse Arx altered enteroendocrine differentiation. In human tissue, cholecystokinin, glucagon-like peptide 1, and somatostatin populations were reduced, whereas the chromogranin A population was unchanged. In the mouse model, cholecystokinin and glucagon-like peptide 1 populations were also lost, although the somatostatin-expressing population was increased. The ARX protein was present in human tissue, whereas the Arx protein was degraded in the mouse intestine.. ARX/Arx is required for the specification of a subset of enteroendocrine cells in both humans and mice. Owing to protein degradation, the Arx mouse recapitulates findings of the intestinal Arx null model, but is not able to further the study of the differential effects of the ARX protein on its transcriptional targets in the intestine.

Topics: Adolescent; Animals; Cell Differentiation; Cholecystokinin; Chromogranin A; Diarrhea; Disease Models, Animal; Duodenal Diseases; Duodenum; Enteroendocrine Cells; Failure to Thrive; Female; Glucagon-Like Peptide 1; Homeodomain Proteins; Humans; Intestinal Pseudo-Obstruction; Male; Mice; Mice, Inbred C57BL; Mutagenesis, Insertional; Peptides; Somatostatin; Steatorrhea; Transcription Factors

To measure content of neuromediators (acetylcholine-Ach, serotonin-5-NT) and gastrointestinal hormones (cholecystokinine-CCK and secretin) in the blood serum of patients with chronic pancreatitis (CP); to study protective properties of the mucus in the duodenum in CP.. CCK and secretin concentrations were estimated by enzyme immunoassay, Ach and 5-NT were measured biochemically basally and after standard meal in 65 CP patients and in the control group. Proteolytic activity of the mucus was assessed by Anson's method. An inhibitory property of the mucus was studied by residual proteolytic activity of pepsine after its incubation with mucus.. In AP patients the response of biologically active substrates to standard meal changed: 5-NT concentration rose from 0.40 +/- 0.07 to 0.55 +/- 0.05 mcg/ml (p < 0.05) while Ach dropped from 1.7 +/- 0.3 to 1.6 +/- 0.3 mmol/l (p > 0.05). BP patients responded to the standard meal with 5-HT concentration rise from 0.28 +/- 0.04 to 0.43 +/- 0.05 mcg/ml (p < 0.05), Ach changed insignificantly (from 1.5 +/- 0.12 to 1.45 +/- 0.21 mmol/l, p > 0.05, reselectively). CCK after standard meal significantly rose both in AP and BP. AP and BP patients had strong direct correlation between concentrations of 5-HT and CCK (r = 0.875439) and weak negative correlation with Ach level (r = -0.2209). In AP and BP patients secretin level weakly negatively correlated both with 5-NT and Ach levels (r = -0.4839 and r = -0.33207, respectively). Reduction of secretin secretion diminished secretion of bicarbonates and mucus with simultaneous change in the quality of mucous gel.. In CP of various etiology there are changes in the level and proportions of neuromediators and hormones causing alterations in the regulation system. These disorders correlate with disturbances in pancreatic excretory function and destructive tissue changes. Bicarbonates secretion decreases and changes quality of the secreted mucus.

Topics: Case-Control Studies; Cholecystokinin; Duodenal Diseases; Female; Humans; Intestinal Mucosa; Male; Middle Aged; Neurotransmitter Agents; Pancreas; Pancreatitis, Chronic; Secretin

The mechanism behind the possible feedback regulation of pancreatic exocrine secretion is not well understood.. Thirteen minipigs were prepared with fistulas to the pancreatic duct and the duodenum. Peripheral venous blood was obtained for determination of secretin and cholecystokinin (CCK) levels. Four different experiments were performed: 1) diversion and reinfusion of pancreatic juice; 2) intraduodenal infusion of NaHCO3 solution, with the same volume, bicarbonate concentration, and osmolality as the collected pancreatic secretion, and reinfusion of pancreatic juice; 3) reinfusion of pancreatic secretion for 1 h before and 2 h after a meal; and 4) diversion of pancreatic secretion and intraduodenal infusion of NaHCO33 solutions before and after a meal.. Reinfusing pancreatic juice significantly decreased pancreatic juice volume and bicarbonate output and slightly decreased the level of secretin in plasma. Alternating infusions of substitute NaHCO3 and pancreatic juice did not change pancreatic output of bicarbonate and protein, nor did it change the CCK and secretin levels in plasma. Replacing pancreatic juice with intraduodenal NaHCO3 infusions during a meal did not significantly modify the pancreatic secretion of bicarbonate and protein or the hormonal levels in blood.. A negative feedback regulation of pancreatic exocrine secretion is present in starved minipigs. Duodenal acidity and plasma levels of secretin semm to be of importance, whereas duodenal enzyme activity and the level of CCK in plasma probably are not. A postprandial negative feedback regulation through duodenal enzymatic activity and release of CCK into blood could not be shown.

Topics: Animals; Cholecystokinin; Duodenal Diseases; Feedback; Food; Intestinal Fistula; Pancreas; Pancreatic Fistula; Pancreatic Juice; Secretin; Sodium Bicarbonate; Starvation; Swine; Swine, Miniature

Duodenogastric reflux of bile and pancreatic secretions is known to induce acute chronic alterations of gastric and oesophageal mucosa. Several complex methods have been reported to demonstrate duodenogastric reflux (DGR) in man. The aim of this work was to describe a simple test for evaluation of DGR. The studied groups included: 1) 30 patients with DGR demonstrated by the radiological test of Capper and by endoscopic examination (group I); 2) 18 subjects without demonstrable DGR (group II). Bilirubin concentrations were measured in gastric juice collected for 10 min periods during one hour before and one hour after gallbladder stimulation by cholecystokinin-pancreozymin (CCK-PZ) (35 Ivy-dog Units). Bilirubin output was determined in the basal state (basal bilirubin output); maximal bilirubin peak (MBP) was determined by the highest of the collected samples following CCK-PZ administration. There was no significant difference between the two groups for basal bilirubin output. Analysis of the MBP showed that the two groups were significantly different (p less than 0.05). A duodenogastric reflux is present and can be quantitated when the MBP is above 200 microgram. Our results suggest that this method is available to evaluate the role of duodenogastric influx in gastric and/or oesophageal diseases.

Topics: Bile Reflux; Biliary Tract Diseases; Bilirubin; Cholecystokinin; Duodenal Diseases; Gastric Juice; Gastrointestinal Motility; Humans; Methods; Pylorus

Topics: Adult; Bilirubin; Cholecystokinin; Duodenal Diseases; Female; Gastric Juice; Humans; Male; Middle Aged; Pylorus; Stomach Diseases

Topics: Adolescent; Child; Cholecystitis; Cholecystokinin; Duodenal Diseases; Duodenal Ulcer; Enteritis; Humans; Pancreatic Diseases; Pancreatitis

Topics: Amylases; Cholecystokinin; Color; Duodenal Diseases; Duodenum; Humans; Starch; Stimulation, Chemical

Topics: Adult; Aged; Cholecystokinin; Cholelithiasis; Duodenal Diseases; False Negative Reactions; False Positive Reactions; Female; Humans; Male; Middle Aged; Pancreatic Diseases; Pancreatic Neoplasms; Pancreatitis; Parotid Gland; Saliva; Secretin

Topics: Adult; Amylases; Cholecystokinin; Cholelithiasis; Chronic Disease; Diagnosis, Differential; Duodenal Diseases; Endoscopy; Female; Glucose Tolerance Test; Humans; Liver Diseases; Male; Middle Aged; Pancreas; Pancreatic Ducts; Pancreatic Neoplasms; Pancreatitis; Radiography; Secretin

Duodeno-gastric reflux has been studied in normal subjects and patients with duodenal and gastric ulceration during the responses to parenteral secretin and cholecystokinin-pancreozymin and to acidification of the small intestine. Reflux was absent or slight in normal subjects and most patients with duodenal ulcer but was appreciable in most patients with gastric ulcer. Duodeno-gastric regurgitation may occasionally resultin a misleading assessment of pancreatic exocrine secretory capacity.

Topics: Bicarbonates; Bile Pigments; Cholecystokinin; Duodenal Diseases; Duodenal Ulcer; Gastric Juice; Humans; Intestinal Secretions; Intestine, Small; Pancreas; Pylorus; Secretin; Stomach Diseases; Stomach Ulcer; Trypsin; Vagotomy

Topics: Amylases; Bile; Biliary Tract Diseases; Cholecystokinin; Chronic Disease; Duodenal Diseases; Duodenum; Enzymes; Gallbladder Diseases; Gastrointestinal Diseases; Humans; Intestinal Secretions; Lipase; Liver Diseases; Pancreatic Diseases; Pancreatic Juice; Pancreatic Neoplasms; Pancreatitis; Secretin

Topics: Animals; Bicarbonates; Blood Pressure; Cholecystokinin; Dogs; Duodenal Diseases; Intestinal Fistula; Pancreas; Prostaglandins; Secretin; Time Factors

Topics: Aged; Ampulla of Vater; Bile Duct Neoplasms; Cholecystokinin; Diverticulum; Duodenal Diseases; Duodenal Ulcer; Duodenum; Endoscopes; Endoscopy; Humans; Intestinal Polyps; Intubation, Gastrointestinal; Male; Methods; Optics and Photonics; Time Factors

Topics: Cholecystokinin; Chronic Disease; Duodenal Diseases; Electrophoresis; Gallbladder; Humans; Stimulation, Chemical