The purpose of this study was to determine whether endogenous release of plasma cortisol during or after induced hypoglycemia would have any appreciable influence on the concomitant gastric acid response over a 4-hr period. No such influence was demonstrated. A significant difference in plasma cortisol response was observed between insulin and tolbutamide, the latter evoking a much smaller and less frequent cortisol response. This study does not support the thesis that a delayed gastric acid response following hypoglycemia is due to an adreno-cortisol influence. The overall implication is that a short-acting stress would not facilitate peptic ulcer formation through a pituitary-adreno-cortical mechanism on gastric acid secretion. However, these findings do not exclude more remote influences of adreno-cortical hormones upon parietal cells.
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Porter, R. W., Movius, H. J., andFrench, J. D. Hypothalamic influences on hydrochloric acid secretion of the stomach.Surgery 33:875, 1953.
French, J. D., Longmire, R. L., Porter, R. W., andMovius, H. J. Extravagal influences on gastric hydrochloric acid secretion induced by stress stimuli.Surgery 34:621, 1953.
Stempien, S. J., Lee, E. R., andDagradi, A. E. Tolbutamide gastric analysis.Amer J Dig Dis 13:643, 1968.
Stempien, S. J., Lee, E. R., andDagradi, A. E. Clinical appraisal of insulin gastric analysis.Amer J Dig Dis 13:21, 1968.
Van der Vies, J. Individual determination of cortisol and corticosterone in a single small sample of peripheral blood.Acta Endocr 38:399, 1961.
Greenwood, F. C., Landon, J., andStamp, T. C. B. The plasma sugar, free fatty acid, cortisol, and growth hormone response to insulin. I. In control subjects.J Clin Invest 45:429, 1966.
Wynn, V. “The Assessment of Hypothalamic-Pituitary-Adrenocortical Function in Man.” InThe Investigation of Hypothalamic-Pituitary-Adrenal Function. James, V. H. T., and Landon, J., Eds. Cambridge University Press, 1968, pp 213–236.
Arner, B., Hedner, P., Karlefors, T., andWestling, H. Haemodynamic changes and adrenal function in man during induced hypoglycaemia.Acta Endocr 44:430, 1963.
Arner, B., Hedner, P., andKarlefors, T. Adrenocortical activity during induced hypoglycaemia.Acta Endocr 40:421, 1962.
Munson, P. L., andBriggs, F. N. The mechanism of stimulation of ACTH secretionRecent Progr Hormone Res 11:83, 1955.
Harris, G. W., Reed, M., andFawcett, C. P. Hypothalamic releasing factors and the control of anterior pituitary function.Brit Med Bull 22:266, 1966.
Gray, S. J., Benson, J. A., Spiro, H. M., andReinfenstein, R. W. Effects of ACTH and cortisone upon the stomach: Its significance in the normal and in peptic ulcer.Gastroenterology 19:658, 1951.
Gray, S. J., Ramsey, C. G., andThorn, G. W. Adrenal influences on the stomach: peptic ulcer in Addison's disease during adrenal steroid therapy.Gastroenterology 45:73, 1956.
Sun, D. C. H. The role of adrenal cortex in the etiology of peptic ulcer.Medecine Hygiene 20:360, 1962.
Shay, H., andSun, D. C. H. “Etiology and pathology of gastric and duodenal ulcer.” (Chap 24). InGastroenterology, Bockus, H. L., Ed. Saunders, 1963, pp 420–465.
Cooke, A. R. Role of adrenocortical steroids in the regulation of gastric secretion.Gastroenterology 52:272, 1967.
Dreiling, D. A., Janowitz, H. D., andRolbin, H. L. The effects of ACTH and adrenocortical steroid hormones on human gastric secretion.Amer J Gastroent 30:269, 1958.
Drye, J. C., andSchoen, A. M. Studies on the mechanisms of the activation of peptic ulcer after non specific trauma.Ann Surg 147:738, 1958.
Hirschowitz, B. I., Streeten, D. H. P., London, J. A., andPollard, H. M. Effects of eight-hour intravenous infusions of ACTH and the adrenocortical steroids in normal man. I. Basal gastric secretion, and plasma and urinary pepsinogen.J Clin Invest 36:1171, 1957.
Williams, E. J., DeCastella, H. C., Lawson, J. O. N., Hopkins, J. D. P., andIrvine, W. T. “The late Acid Response to Insulin induced Hypoglycaemia and its relation to Vagal Stimulated Gastrin Release.” (chap 11), InGastric Secretion, Pergamon Press Ltd. 1967, pp 135–147.
Davis, R. A., andBrooks, F. P. Gastric secretion, continuously recorded blood sugar, and plasma steroids after insulin.Amer J Physiol 204:143, 1963.
Krawiec, J., Straughn J., andPolish, E. The biphasic gastric secretory response in man.Amer J Dig Dis 10:985–992, 1965.
Sircus, W., Huston, C. J. W., Preshaw, R. M., Bassoe, H., andHarkness, R. A. Studies in dogs on the biphasic nature of the gastric secretory response to hypoglycaemia and other stimuli with special reference to the role of the adrenals.Gut 4:42, 1963.
Zubiran, J. M., Kark, A. E., andDragstedt, L. R. The effect of ACTH on gastric secretion in experimental animals.Gastroenterology 21:276, 1952.
Plainos, T. C., andPhilippu, A. J. The effect of prednisone (Meticorten) on gastric secretion and urine and uropepsin excretion in the dog.Gastroenterology 35:183, 1958.
McGee, L. S., Blackburn, J., Lance, E. M., andScott, H. W., Jr. The secretory response of the denervated gastric pouch to prolonged massive cortisone administration.Surg Forum 9:440, 1959.
Plainos, T. C., Nikitopulu, G. K., andVukydis, P. K. The effect of triamcinolone and dexamethasone on gastric secretion and the excretion of uropepsin tested in dogs.Gastroenterology 43:448, 1962.
Chaikof, L., Janke, W. H., Pesaros, P. C., Ponka, J. L., andBrush, B. E. Effects of prednisone and corticotropin on gastric secretion.Archives of Surg 83:32, 1961.
Clarke, S. D., Neill, D. W., andWelbourn, R. B. The effects of corticotrophin and corticoids on secretion from denervated gastric pouches in dogs.Gut 1:36, 1960.
Reid, N. C. R. W., Hackett, R. M., andWelbourn, R. B. The influence of cortisone on the parietal cell population of the stomach in the dog.Gut 2:119, 1961.
Crean, G. P. Effect of hypophysectomy on the gastric mucosa of the rat. A comparison between the effects of hypophysectomy and adrenalectomy on the gastric mucosa of the rat.Gut 9:332–342, 343–347, 1968.
Sun, D. C. H., andShay, H. Potentiation of mecholyl or histamine-stimulated gastric secretion by hydrocortisone in heidenhain pouch dogs.Physiologist 1:77, 1958.
Welbourn, R. B., andCode, C. F. Effects of cortisone and of adrenalectomy on secretion of gastric acid and on occurrence of gastric ulceration in the pylorus-ligated rat.Gastroenterology 23:356, 1953.
Sun, D. C. H. Gastric secretory response to insulin hypoglycemia in fistula dogs before and after adrenalectomy.Fed Proc 23:118, 1964.
Bralow, S. P., Komarov, S. A., andShay, H. Effect of total adrenalectomy on gastric secretion in chronic gastric fistula rats.Amer J Physiol 206:1309, 1964.
Cooke, A. R., Preshaw, R. M., andGrossman, M. I. Effect of adrenalectomy and glucocorticoids on the secretion and absorption of hydrogen ion.Gastroenterology 50: 761, 1966.
Cooke, A. R. Acid and pepsin responses to gastrin in Heidenhain pouch dogs following bilateral adrenalectomy.Gut 8:588, 1967.
Cooke, A. R., Nahrwold, D. L., andGrossman, M. I. Effect of bilateral adrenalectomy on gastric acid and pepsin secretion from gastric fistulas and Heidenhain pouches in dogs.Gastroenterology 52:488, 1967.
Shay, H., andSun, D. C. H. Stress and gastric secretion in man. I. A study of the mechanism involved in insulin hypoglycemia.Amer J Med Sci 228:630, 1954.
Stempien, S. J., French, J. D., Dagradi, A. E., Movius, H. J., II, andPorter, R. W. The early and delayed phases of gastric acid secretion in response to insulin hypoglycemia. I. The hypoglycemic secretory responses in duodenal ulcer patients and non-ulcer subjects.Gastroenterology 34:104, 1958.
Stempien, S. J., Dagradi, A. E., andSeifer, H. W. Status of duodenal ulcer patients five years or more after vagotomy-pyloroplasty.World Congress of Gastroenterology, Washington DC 2:1026, 1958.
Bachrach, W. H. On the question of a pituitary-adrenal component in the gastric secretory response to insulin hypoglycemia.Gastroenterology 44:178, 1963.
Supported in part by a grant from the Ciba Pharmaceutical Company.
The author gratefully acknowledges the assistance of Miss Sylvia McCable. Mr. Joseph Cottingham, Mrs. Elizabeth Baum, Mrs. Lorraine Eiynck, and Mrs. Nina Lee.
We are indebted to Dr. Benjamin Horwitt and to Bio-Science Laboratories, Van Nuys, Calif, for their assistance in plasma cortisol determinations.
Statistical evaluations were made by Donald C. Butler, PhD, Statistician, Western Research Support Center, Sepulveda, Calif.
Tolbutamide (Orinase Diagnostic) was generously supplied by the Upjohn Company.
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Stempien, S.J. Neuro-endocrine influences on human gastric secretion. Digest Dis Sci 14, 875–886 (1969). https://doi.org/10.1007/BF02233209
- Peptic Ulcer
- Gastric Acid
- Acid Secretion