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Assessment of pancreatic enzyme secretory capacity by a modified Lundh test

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Summary

Background. The Lundh test is a usual means of estimating the enzyme secretory capacity of the gland. During this procedure, however, a major proportion of the test meal is removed from the duodenum together with the gastric, duodenal, and pancreatic secretions and the bile. This study was undertaken to compare the pancreatic enzyme secretion induced by the Lundh procedure with that resulting from stimulation of the normal digestive process, by reinfusion of the aspirated duodenal juice.

Methods. Nine men (mean age: 46.7, range 42–55 yr) free from pancreatic disease were studied. Pancreatic secretion was measured via a multiple lumen tube by aspiration of the duodenal juice. After a basal period the Lundh test meal was placed in the stomach and the duodenal juice was completely aspirated. On a separate day, the procedure was repeated, but the aspirated duodenal juice was reinfused into the upper jejunum.

Results. In the first 30 min of the test period, the enzyme outputs were the same on both test days. In the 30–60-min period, the lipase output, and in the 75–90-min period, the amylase output was significantly lower during the Lundh test compared with the jejunal reinfusion test. The CCK levels were significantly above the basal level at 20 and 40 min, but the increase was significantly lower during the traditional Lundh test. No significant difference in gastrin release was observed during either the Lundh or the reinfusion test.

Conclusions. In the traditional Lundh test, the trypsin secretory capacities of the gland are measured appropriately, but the lipase and amylase secretory capacity and the CCK release are not fully represented compared with the reinfusion test. An association between the lower CCK release and lipase amylase secretion is suggested.

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References

  1. Solomon TE. Control of exocrine pancreatic secretion. In Physiology of the Gastrointestinal Tract, vol. 2, 3rd ed., Johnson LR, ed. Raven Press, New York 1994; pp. 1499–1529.

    Google Scholar 

  2. Case RM. Pancreatic exocrine secretion: mechanisms and control. In The Pancreas, vol. 1, Beger HG, Warshaw AL, Buchler MW eds. Blackwell Science, Oxford, United Kingdom, 1998; pp. 63–100.

    Google Scholar 

  3. Lundh G. Pancreatic exocrine function in neoplastic and inflammatory disease: a simple and reliable new test. Gastroenterol 1962; 42: 275–280.

    CAS  Google Scholar 

  4. Bozkurt T, Adler G, Leferink S, Arnold R. Volume and enzyme kinetics of human pancreatic secretion after endogenous stimulation with the Lundh test meal. Int J Gastroenterol 1990; 6: 281–283.

    CAS  Google Scholar 

  5. Hajnal F, Flores MC, Radley S, Valenzuela JE. Effect of alcohol and alcoholic beverages on meal-stimulated pancreatic secretion in humans. Gastroenterol 1990; 98: 191–196.

    CAS  Google Scholar 

  6. Hyden S. A turbidimetric method for the determination of higher polyethylene glycols in biological materials. Lant Brushogsk Ann 1956; 22: 139–145.

    CAS  Google Scholar 

  7. Ceska M, Birath K, Brown B. A new and rapid method for the clinical determination of amylase activities in human serum and urine. Clin Chem Acta 1969; 26: 437–444.

    Article  CAS  Google Scholar 

  8. Bartik M, Chavko M, Kasafirek E. Nalpha-tosyl-L-arginine-p-nitroanilide as substrate in color test and polarographic test of trypsin. Clin Chim Acta 1974; 56: 23–30.

    Article  PubMed  CAS  Google Scholar 

  9. Honegger J, Hadorn B. The determination of lipase activity in human duodenal juice. Biol Gastroenterol 1973; 6: 217–223.

    CAS  Google Scholar 

  10. Liddle R, Goldfine I, Rosen M, Taplitz R, Williams J. Cholecystokinin bioactivity in human plasma: molecular forms, responses to feeding, and relationship to gallbladder contraction. J Clin Invest 1985; 75: 1144–1152.

    Article  PubMed  CAS  Google Scholar 

  11. Remák G, Penke B, Németh J, Baláspiri L, Varga L. Experiences with the development of the radioimmunoassay of 15-Leu-Gastrin. Izotóptechnika 1980; 23: 266–279.

    Google Scholar 

  12. Scarpello JH, Vinik AI, Owyang C. The intestinal phase of pancreatic polypeptide release. Gastroenterology 1982; 82: 406–412.

    PubMed  CAS  Google Scholar 

  13. Adler G, Nelson DK, Katschinski M, Beglinger C. Neurohormonal control of human pancreatic exocrine secretion. Pancreas 1995; 10: 1–13.

    Article  PubMed  CAS  Google Scholar 

  14. DiMagno EP, Go VLW, Summerskill WHJ. Intraluminal and postabsortive effects of amino acids on pancreatic enzyme secretion. J Lab Clin Med 1973; 82: 241–248.

    PubMed  CAS  Google Scholar 

  15. Ertan A, Brooks FP, Ostrow JD, Arvan DA, Williams CN, Cerda JJ. Effect of jejunal amino acid perfusion and exogenous cholecystokinin on the exocrine pancreatic and biliary secretions in man. Gastroenterology 1971; 61: 686–692.

    PubMed  CAS  Google Scholar 

  16. Brugge WR, Burke CA, Izzo RS, Praissman M. Role of cholecystokinin in intestinal phase of human pancreatic secretion. Dig Dis Sci 1987; 32: 155–163.

    Article  PubMed  CAS  Google Scholar 

  17. Vidon N, Hecketsweiler P, Butel J, Bernier JJ. Effetct of continuous jejunal perfusion of elemental and complex nutritional solutions on pancreatic enzyme secretion in human subjects. Gut 1978; 19: 194–198.

    Article  CAS  Google Scholar 

  18. Owyang C, Louie DS, Tatum D. Feedback regulation of pancreatic enzyme secretion. Suppression of cholecystokinin by release of trypsin. J Clin Invest 1986; 77: 2042–2047.

    Article  PubMed  CAS  Google Scholar 

  19. Jin HO, Song CW, Chang TM, Chey WY. Roles of gut hormones in negative feedback regulation of pancreatic exocrine secretion in human. Gastroenterology 1994; 107: 1828–1834.

    PubMed  CAS  Google Scholar 

  20. Chey WY. Neurohumoral control of the exocrine pancreas. Curr Opin Gastroenterol 1997; 13: 375–380.

    Article  CAS  Google Scholar 

  21. Layer P, Peschel S, Schlesinger T, Goebell H. Human pancreatic secretion and intestinal motility: effects of nutrient perfusion. Am J Physiol 1990; 258: G196–201.

    PubMed  CAS  Google Scholar 

  22. Groger G, Unger A, Holst JJ, Goebell H, Layer P. Ileal carbohydrates inhibit cholinergically stimulated exocrine pancreatis secretion in humans. Int J Pancreatol 1997; 22: 23–29.

    PubMed  CAS  Google Scholar 

  23. Owyang C, Green L, Rader D. Colonic inhibition of pancreatic and biliary secretion. Gastroenterol 1983; 84: 470–475.

    CAS  Google Scholar 

  24. Adelson JW, Miller PE. Heterogeneity of the exocrine pancreas. Am J Physiol 1989; 256: G817-G825.

    PubMed  CAS  Google Scholar 

  25. Maouyo D, Morisset J. Amazing pancreas: specific regulation of pancreatic secretion of individual digestive enzymes in rat. Am J Physiol 1995; 268: E349-E359.

    PubMed  CAS  Google Scholar 

  26. Maouyo D, Morisset J. Modulation of pancreatic secretion of individual digestive enzymes in octreotide (SMS 201–995)-infused rats. Pancreas 1997; 14: 47–57.

    Article  PubMed  CAS  Google Scholar 

  27. Pfeiffer A, Vidon N, Feurle GE, Chayvialle JA, Bernier JJ. Effect of jejunal infusion of different caloric loads on pancreatic enzyme secretion and gastro-intestinal hormone response in man. Eur J Clin Invest 1993; 23: 57–62.

    Article  PubMed  CAS  Google Scholar 

  28. Czakó L, Hajnal F, Németh J, Takács T, Lonovics J. Effect of a liquid meal given as a bolus into the jejunum on human pancreatic secretion. Pancreas 1999; 18: 197–202.

    Article  PubMed  Google Scholar 

  29. Liddle RA. Cholecystokinin, in Gut Peptides: Biochemistry and Physiology, Walsh JH, Dockray GJ, eds. Raven Press, New York, 1994; pp. 175–188.

    Google Scholar 

  30. Walsh JH. Gastrin, in Gut Peptides: Biochemistry and Physiology, Walsh JH, Dockray GJ, eds. Raven Press, New York, 1994; pp. 75–122.

    Google Scholar 

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Authors and Affiliations

  1. First Department of Medicine, Albert Szent-Györgyi Medical University, P.O.Box:469, H-6701, Szeged, Hungary

    László Czakó, Ferenc Hajnal, József Németh & János Lonovics

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  1. László Czakó
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  2. Ferenc Hajnal
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  3. József Németh
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  4. János Lonovics
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Correspondence to László Czakó.

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Czakó, L., Hajnal, F., Németh, J. et al. Assessment of pancreatic enzyme secretory capacity by a modified Lundh test. International Journal of Pancreatology 27, 13–19 (2000). https://doi.org/10.1385/IJGC:27:1:13

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