Abstract
Plasma secretin concentrations were determined in healthy subjects and patients with duodenal ulcer, achlorhydria, and celiac sprue. Mean fasting plasma secretin concentrations in 26 healthy subjects and 26 duodenal ulcer patients were 6.7±0.5 and 10.2±1.2 pg/ml, respectively, and were significantly different (P<0.02). After ingestion of a standard meat meal, pyloric pH decreased to less than 4.5 within 15 min and plasma secretin concentrations significantly increased in all 52 subjects. In 14 subjects (seven healthy subjects and seven patients with duodenal ulcer), no significant rise in plasma secretin concentration occurred when pyloric pH was maintained at greater than 5.0 by intravenous cimetidine (600 mg) and intragastric antacid. In 10 achlorhydric patients, intragastric pH remained greater than 5.0 after the meal and plasma secretin concentrations did not change. However, plasma secretin concentrations increased significantly when 0.1 N HCl was infused in the stomach (25 mEq/hr) during the postprandial period. In all eight adult patients with celiac disease (seven untreated, one partially treated), pyloric pH remained less than 4.0 after a meal. Postprandial secretin concentrations did not increase significantly in six and showed a transient rise in two. These studies show that (1) plasma secretin concentration increases significantly after meals in healthy subjects and patients with duodenal ulcer; (2) neutralization of gastric acid and the achlorhydric state show no significant postprandial rise in plasma secretin concentration; (3) achlorhydric patients do not have a defect in secretin release in response to acid; and (4) failure of postprandial rise in plasma secretin in patients with celiac disease is attributed to impaired release of secretin and in achlorhydric patients it is attributed to lack of acid secretion.
Similar content being viewed by others
References
Bayliss W, Starling EH: Mechanisms of pancreatic secretion. J Physiol 28:325–353, 1902
Mutt V, Magnusson S, Jorpes JE, Dahl E: Structure of porcine secretin I. Degradation with trypsin and thrombin. Sequence of the tryptic peptides. The C-terminal residue. Biochemistry 4:2358–2362, 1965
Boden G, Chey WY: Preparation and specificity of antiserum to synthetic secretin and its use in a radioimmunoassay (RIA). Endocrinology 92:1617–1624, 1973
Chey WY, Rhodes RA, Lee KY, Tai HH, Hendricks J: Radioimmunoassay of secretin: Further studies.In Gastrointestinal Hormones, JC Thompson (ed). Austin, University of Texas Press, 1975, pp 269–281
Bloom SR. The development of a radioimmunoassay for secretin.In Gastrointestinal Hormones, JC Thompson (ed). Austin, University of Texas Press, 1975, pp 257–268
Fahrenkrug J, Schaffalitzky de Muckadel OB: Plasma secretin concentration in man: effect of intraduodenal glucose, fat, amino acid, ethanol, HCl or ingestion of a meal. Eur J Clin Invest 7:200–203, 1977
Rayford PL, Curtis PJ, Fender HR, Thompson JC: Plasma levels of secretin in man and dog: Validation of a secretin radioimmunoassay. Surgery 79:658–665, 1976
Straus E: Radioimmunoassay of gastrointestinal hormones. Gastroenterology 74:141–152, 1978
Boden G, Essa N, Owen E, Reichle F, Saraga W: The effects of intraduodenal administration of HCl and glucose on circulating immunoreactive secretin and insulin concentration. J Clin Invest 53:1185–1193, 1974
Chey WY, Lee YH, Hendricks JG, Rhodes RA, Tai HH: Plasma secretin concentrations in fasting and postprandial state in man. Am J Dig Dis 23:981–988, 1978
Schaffalitzky de Muckadell OB, Fahrenkrug J: Secretion pattern of secretin in man: Regulation by gastric acid. Gut 19:812–818, 1978
Pelletier MJ, Chayvialle JAP, Minaire Y: Uneven and transient secretin release after a liquid test meal. Gastroenterology 75:1124–1132, 1978
Kim MS, Lee KY, Chey WY: Plasma secretin concentrations in fasting and postprandial states in dog. Am J Physiol 236:E539–544, 1979
Chey WY, Kim MS, Lee KY, Chang T-M: Effect of rabbit antisecretin serum on postprandial pancreatic secretion in dogs. Gastroenterology 77:1268–1275, 1979
Tai HH, Chey WY: Simultaneous radioimmunoassay of secretin and gastrin. Anal Biochem 74:12–24, 1976
Tai HH, Chey WY: Rapid extraction of secretin from plasma by XAD-2 resin and its application in the radioimmunoassay of secretin. Anal Biochem 87:376–385, 1978
Fordtran JS, Walsh JH: Gastric acid secretion rate and buffer content of the stomach after eating. J Clin Invest 52:645–657, 1973
Malagelada JR, Longstreth GF, Summerskill WHJ, Go VLW: Measurement of gastric functions during digestion of ordinary solid meals in man. Gastroenterology 70:203–210, 1976
Bloom SR, Patel HR, Johnston DI: Failure of secretin release of coelic disease. Gut 17:812, 1976
O'Connor FA, McLoughlin JC, Bouchanan KD: Impaired immunoreactive secretin release in coeliac disease. Br Med J 1:811, 1977
Rhodes RA, Tai HH, Chey WY: Impairment of secretin release in celiac sprue. Am J Dig Dis 23:833–839, 1978
Rhodes RA, Chey WY, Tai HH, Escoffery RG: Impaired release of secretin in celiac sprue. Clin Res 24:290A, 1976
Stolund K, Alumets J, Berg N-O, Hakanson R, Sundler F: Duodenal endocrine cells in adult coeliac disease. Gut 20:547–552, 1979
Author information
Authors and Affiliations
Additional information
This work was supported by The Genesee Hospital Gastrointestinal Research Fund and U.S. Public Health Research Grant NIH AMDD 25962.
Rights and permissions
About this article
Cite this article
Rominger, J.M., Chey, W.Y. & Chang, TM. Plasma secretin concentrations and gastric pH in healthy subjects and patients with digestive diseases. Digest Dis Sci 26, 591–597 (1981). https://doi.org/10.1007/BF01367670
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01367670