cholecystokinin and Liver-Diseases

Topics: Alkaline Phosphatase; Bone and Bones; Cholecystokinin; Dietary Fats; Electrophoresis, Polyacrylamide Gel; Female; Humans; Intestinal Absorption; Intestine, Small; Isoenzymes; Kinetics; Liver Diseases; Molecular Weight; Neoplasms; Phenotype; Placenta; Polyethylene Glycols; Pregnancy; Radioimmunoassay; Secretin; Subcellular Fractions; Urea

Topics: Animals; Anura; Bile; Bile Acids and Salts; Bile Ducts; Bilirubin; Cholagogues and Choleretics; Cholecystokinin; Coumarins; Dehydrocholic Acid; Gallbladder; Humans; Liver; Liver Cirrhosis; Liver Diseases; Male; Rats; Scopoletin; Secretin; Taurocholic Acid

Topics: Amylases; Celiac Disease; Cholecystokinin; Duodenum; Fasting; Food; Food Analysis; Humans; Intubation, Gastrointestinal; Liver Diseases; Pancreas; Pancreatic Diseases; Pancreatic Neoplasms; Secretin; Time; Trypsin

Artificial nutrition is frequently associated with hepatobiliary complications, probably due to the inherent derangement of the gastrointestinal tract physiology. Alterations of hepatic lipid metabolism are likely to be involved. The aim of the present study was to investigate the effect of artificial nutrition on bile acid production, a key event in cholesterol homeostasis, in humans.. Eleven patients receiving artificial nutrition, either parenteral nutrition (PN; n = 6) or enteral nutrition (EN; n = 5) with no previous history of liver disease, underwent analysis of cholesterol 7α-hydroxylation rates in vivo, a measure of bile acid formation, by isotope release analysis after intravenous injection of [7α-(3)H]cholesterol. The results were compared with those obtained in a population of 16 age-matched control subjects.. Hydroxylation rates were lower in patients with artificial nutrition (PN: 94 ± 13 mg/d; EN: 230 ± 39 mg/d, mean ± SEM) when compared with controls (385 ± 47 mg/d) (P < .01, 1-way analysis of variance). In a patient receiving EN, hydroxylation rates increased 3.5-fold after treatment with the cholecystokinin analogue ceruletide (20 µg bid for 2 weeks intramuscularly). Serum lathosterol-to-cholesterol ratio, a marker of cholesterol synthesis, was also significantly reduced in artificial nutrition, whereas serum levels of fibroblast growth factor 19 (FGF19) were increased.. In vivo 7α-hydroxylation is suppressed in artificial nutrition, particularly in PN. The finding associates with reduced cholesterol production, possibly as a metabolic consequence. The data suggest a regulatory role of gastrointestinal hormones and FGF19 on bile acid production and might suggest a pathophysiological basis for some common complications of artificial nutrition, such as gallstone disease and cholestasis.

Topics: Administration, Intravenous; Adult; Aged; Bile Acids and Salts; Body Mass Index; Body Weight; Cholecystokinin; Cholesterol; Enteral Nutrition; Female; Fibroblast Growth Factors; Gastrointestinal Hormones; Gastrointestinal Tract; Homeostasis; Humans; Hydroxylation; Linear Models; Lipid Metabolism; Liver; Liver Diseases; Male; Middle Aged; Parenteral Nutrition

The inhibitory effect of different reperfusion periods 45 min following hepatic ischemia on the expression of cholecystokinin (CCK) and vasoactive intestinal peptide (VIP) in the jejunum and the effect of salvia miltiorrhiza pretreatment were investigated, and the possible mechanism and implications were explored. Eighty rats were randomly divided into four groups: normal control group (CO group), sham-operated group (SO group), ischemia/reperfusion (I/R) injury group (IR group) and salvia miltiorrhiza pretreatment group (SM group). The rat model of I/R was established by using a non-invasive artery clamp to clip (45 min) or relax the hepatic pedicle. In the SM group, saline (40 mL/kg) and salvia miltiorrhiza injection (6 g/kg) were injected via the tail vein 30 min before clipping the hepatic pedicle. In the SO group only the porta hepatis was dissected after laparotomy without clamping the hepatic pedicle. At 0, 3, 12, 24 and 72 h post-reperfusion, respectively, upper jejunum samples were taken for immunohistochemistry of CCK and VIP. It was found that 0 h after I/R, the expression of CCK and VIP in the upper jejunum was upregulated. With prolongation of the reperfusion period, the expression of CCK and VIP was also increased, reached the peak at the 24th h, and gradually returned to the normal level at the 72nd h after reperfusion. The levels of both CCK and VIP in the SM group were lower than those in the IR group. It is suggested that the digestive tract congestion injury caused by liver ischemia can upregulate the expression of CCK and VIP in the jejunum following reperfusion. Salviae pretreatment can partly reduce the increased expression of CCK and VIP in the jejunum in the same period, which might contribute to the early recovery of gastrointestinal motility.

Topics: Animals; Cholecystokinin; Gastrointestinal Motility; Intestinal Mucosa; Jejunum; Liver; Liver Diseases; Phytotherapy; Rats; Rats, Sprague-Dawley; Reperfusion Injury; Salvia miltiorrhiza; Vasoactive Intestinal Peptide

Pancreatic function can only be determined exactly via the pancreozymin-secretin test. We conducted this test in two versions: (1) under conditions of continuous perfusion with the possibility of volume correction and (2) as a simple tubing. We compared the results of 86 tubings with the results of 87 examinations under perfusion. For that purpose all patients were classified into four groups: group a) with 46 and 10 examinations, respectively, in patients suffering from cholestasis in early infancy, group b) with 7 and 12 examinations, respectively, in older patients with liver diseases, group c) with 8 and 17 examinations, respectively, in patients suffering from cystic fibrosis or Shwachman's syndrome and group d) with 25 and 48 examinations, respectively, in children with normal pancreatic function. Both examination methods nearly identical mean values of the enzyme activities in all four patient groups. However, mean variations were found to be higher in case of tubing. Therefore the lower limits (x - 2s) of this test were defined at a lower level than those of the tests under perfusion.

Topics: Amylases; Child; Child, Preschool; Cholecystokinin; Cystic Fibrosis; Diagnosis, Differential; Exocrine Pancreatic Insufficiency; Humans; Infant; Infant, Newborn; Intestinal Secretions; Jaundice, Neonatal; Lipase; Liver Diseases; Pancreatic Function Tests; Reference Values; Secretin; Trypsin

By means of consecutive pancreatic stimulation, we have investigated the presence of changes of pancreatic function in alcoholic patients, with and without alcoholic liver disease, in order to detect functional alterations and possible association of hepatic and pancreatic disease. The patients were 49 chronic alcoholics (8 patients without liver disease, 11 hepatic steatosis, 9 alcoholic hepatitis and 21 alcoholic cirrhosis) and 15 non alcoholic subjects (8 normal controls and 7 cases of non alcoholic cirrhosis). In all the cases two consecutive stimulations were carried out: first with secretin and cholecystokinin (CCK) and second with CCK alone. The total volume and concentration as well as the output of bicarbonate, trypsin, amylase and total proteins were measured in the duodenal juice. Patients with alcoholic cirrhosis had larger volumes of duodenal juice and lower concentrations of bicarbonate, enzymes and proteins. There was also a tendency to larger volume and lower bicarbonate concentration as the hepatic lesion was more severe. Bicarbonate output was significatively higher in patients with alcoholic cirrhosis but for the remaining parameters the outputs were similar in all the groups. In conclusion, the alterations in pancreatic function parallel the severity of the liver disease. None of the patients had changes consistent with chronic pancreatitis.

Topics: Adult; Aged; Cholecystokinin; Duodenum; Gastrointestinal Contents; Humans; Liver Diseases; Liver Diseases, Alcoholic; Middle Aged; Pancreas; Pancreatic Juice; Secretin

A decrease of both hypothalamic and cortical CCK occurred in the brain of rats killed 8 hours after hepatic artery ligation following portocaval anastomosis. Brain CCK depletion was not reproduced by exogenously provoked hyperammonemia nor by insulin-induced hypoglycemia, thus suggesting a central mechanism for the derangement of the CCKergic system in the course of acute liver failure.

Topics: Ammonia; Animals; Blood Glucose; Brain; Cerebral Cortex; Cholecystokinin; Disease Models, Animal; Hypothalamus; Liver Diseases; Male; Rats; Rats, Inbred Strains

Topics: Cholecystokinin; Cholelithiasis; gamma-Glutamyltransferase; Humans; Liver Cirrhosis; Liver Diseases; Secretin

Assessment of the clinical value of the pancreolauryl test (PLT) in the literature range from "useless" to a specifity of 95% and a sensitivity of 98%. In this work, our own data are presented in relation to various reference methods. The results are derived from the largest collective investigated to data, comprising 40 controls and 391 patients (108 with chronic pancreatitis and 283 with other gastrointestinal disorders). The specifity of the the PLT varies between 81% and 95% according to the "quality" of the control collective. The PLT is particularly frequently pathological in patients with diseases in the region of the gallbladder/bile duct and the gastrointestinal tract. The sensitivity of the PLT for chronic pancreatitis varies between 68% and 100%, depending on 9 different reference methods employed. Based on the prevalence of chronic pancreatitis with exocrine insufficiency in various patient collectives, the predictive value of the PLT for the presence of this disorder can be calculated using our data.

Topics: Cholangiopancreatography, Endoscopic Retrograde; Cholecystokinin; Cholelithiasis; Chronic Disease; Chymotrypsin; Diagnosis, Differential; Exocrine Pancreatic Insufficiency; Gastrointestinal Diseases; Humans; Liver Diseases; Pancreatic Diseases; Pancreatic Function Tests; Pancreatitis; Secretin; Tomography, X-Ray Computed

Topics: Amino Acids; Ammonia; Animals; Brain Chemistry; Cholecystokinin; Hepatic Encephalopathy; Liver Diseases; Peripheral Nervous System Diseases; Portacaval Shunt, Surgical; Rats; Rats, Inbred Strains

Topics: Biliary Tract Diseases; Cholecystokinin; Drug Combinations; Female; Humans; Liver Diseases; Male; Morphine; Neostigmine; Radionuclide Imaging

Size of gallbladder after overnight fasting and the kinetics of gallbladder contraction following i.v. injection of 1 I. U. of CCK was investigated in patients with chronic liver disease (liver cirrhosis: n = 26; chronic hepatitis: = 12; fatty liver: n = 5). The results were compared with those obtained in an age and sex matched control group of subjects without symptoms of diseases of the liver or gastrointestinal tract (n = 15). Ultrasound was used for continuous monitoring of gallbladder emptying. In the cirrhotics the cartographically determined initial area of the gallbladder was significantly greater than in the controls (p less than 0,01). The kinetic of gallbladder emptying following CCK-pancreozymin stimulation was similar in the groups of patients with liver diseases to that of the control subjects. However, the residual area of the gallbladder following maximal contraction was again significantly greater in the cirrhotics when compared to the control group (p less than 0.05). The area of the gallbladder in patients with chronic hepatitis exhibited similar changes of the values in the fasting state and after maximal contraction as seen in the patients with liver cirrhosis, although the differences when compared to the control group were not significant. The results show that in spite of distinct signs of a hypotonic state of the unstimulated gallbladder in patients with chronic liver disease the kinetic of contraction following an exogenous stimulus with CCK remains normal.

Topics: Adult; Aged; Cholecystokinin; Cholelithiasis; Fatty Liver; Female; Gallbladder; Hepatitis; Humans; Kinetics; Liver Cirrhosis; Liver Diseases; Male; Middle Aged; Muscle Contraction; Ultrasonography

Topics: Bile; Biliary Tract Diseases; Cholecystokinin; Chronic Disease; Humans; Liver; Liver Diseases

Topics: 4-Aminobenzoic Acid; Aminobenzoates; Biliary Tract Diseases; Cholecystokinin; Evaluation Studies as Topic; Humans; Liver Diseases; Pancreatic Diseases; Pancreatic Function Tests; para-Aminobenzoates; Secretin; Tyrosine

Topics: Amylases; Biliary Tract Diseases; Cholecystokinin; Duodenum; Humans; Intestinal Secretions; Liver Diseases; Pancreatic Diseases; Ribonucleases; Secretin

After a review of the literature the author's results of testing pancreatic function in 445 patients with different diseases are reported. The activities of serum amylase and lipase were estimated before and after stimulation with secretin and pancreozymin; at the same time exocrine secretions of the pancreas were collected in the duodenum and analyzed. Serum enzyme activity did not change markedly after stimulation in pronounced pancreatic insufficiency. Measuring the enzyme activity thus helped to make the diagnosis only in a few cases with chronic pancreatitis and pancreatic carcinoma. In all other patients there was no correlation between changes of serum enzyme activities and changes of exocrine pancreatic function. Pathological test results, that means an increase in enzyme activity after stimulation, were found not only in patients with established or suspected pancreatic diseases, but also in many other subjects. Thus the diagnostic relevance of these tests seems to be rather limited, since it does not prove or exclude with sufficient specificity or adequate probability the presence of pancreatic diseases; it therefore cannot be recommended for screening purposes.

Topics: Amylases; Cholecystokinin; Chronic Disease; Diabetes Mellitus; Enzymes; Gastrointestinal Diseases; Humans; Kidney Failure, Chronic; Lipase; Liver Diseases; Pancreatic Neoplasms; Pancreatitis; Secretin

Investigating patients with chronic diseases of the liver, there will sometimes be found a symmetric hypertrophy of the parotid glands. Supposing, that enlargement of the parotid glands could equal an enhancement of parotid function, the authors investigated amylase and volume production of the parotid glands and at the same time that produced by pancreatic excretion during pancreozymin/secretin stimulation. They found a compensatory action of the parotidean function: In patients with only small liver cell damage they saw a diminished parotidean function together with an enhanced pancreatic excretion. In cases with severe liver cell alteration, the parotidean function was found to be greater than in normals, the pancreatic function diminished. The authors estimate the parotidean hypertrophy as a morphologic equivalent to the compensatory enhancement of parotidean function in cases with chronic liver diseases.

Topics: Amylases; Cholecystokinin; Chronic Disease; Duodenum; Intestinal Secretions; Liver Diseases; Pancreas; Parotid Gland; Saliva; Secretin

Topics: Cholecystokinin; Cholestasis; Diagnosis, Differential; Humans; Liver Diseases; Secretin

Topics: Cholangiography; Cholecystokinin; Chronic Disease; Endoscopy; Humans; Liver Diseases; Pancreas; Secretin

Topics: Cholangiography; Cholecystokinin; Endoscopy; Humans; Liver; Liver Diseases; Pancreas; Pancreatic Diseases; 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

Topics: Adolescent; Adult; Aged; Biliary Tract Diseases; Cholecystokinin; Female; Humans; Liver Diseases; Male; Middle Aged; Secretin

Topics: Bile Acids and Salts; Cholecystokinin; Chronic Disease; Circadian Rhythm; Duodenum; Fasting; Female; Gallbladder; Hepatitis; Humans; Liver Cirrhosis; Liver Diseases; Male; Taurocholic Acid

Topics: Adolescent; Bile Acids and Salts; Bile Ducts; Bile Ducts, Intrahepatic; Body Weight; Celiac Disease; Child; Child, Preschool; Cholecystokinin; Cholestyramine Resin; Chronic Disease; Diet Therapy; Dietary Fats; Duodenum; Female; Humans; Infant; Intestinal Secretions; Liver Cirrhosis; Liver Diseases; Liver Function Tests; Male; Triglycerides

Topics: Adult; Aged; Angiography; Biliary Tract Diseases; Blood Flow Velocity; Celiac Artery; Cholecystokinin; Contrast Media; Female; Gallbladder; Humans; Intestine, Small; Liver Circulation; Liver Diseases; Male; Mesenteric Arteries; Middle Aged; Oxygen Consumption; Pancreas; Pancreatic Diseases; Pancreatic Neoplasms; Regional Blood Flow; Time Factors; Vascular Resistance

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: Alcoholism; Amylases; Bicarbonates; Cholecystokinin; Humans; Liver Cirrhosis; Liver Diseases; Pancreas; Pancreatitis; Secretin

Topics: Biliary Tract Diseases; Cholecystokinin; Duodenum; Gastrointestinal Diseases; Humans; Liver Diseases; Pancreatic Diseases; Pancreatitis; Secretin

Topics: Amyloidosis; Biochemical Phenomena; Biochemistry; Cholangitis; Cholecystitis; Cholecystokinin; Colonic Neoplasms; Drug Therapy; Duodenum; Electrophoresis; Enteritis; Gastritis; Hemosiderosis; Humans; Intestinal Secretions; Leucyl Aminopeptidase; Liver Cirrhosis; Liver Diseases; Melanoma; Mucous Membrane; Nephrosis; Pancreatitis