Bile acids in human plasma interfere with cholecystokinin bioassay using dispersed pancreatic acini

Miyasaka, Kyoko; Funakoshi, Akihiro; Matsumoto, Masahiro; Nakamura, Rieko; Sakamoto, Shigeru; Sakai, Hironori; Kitani, Kenichi

doi:10.1007/bf01318202

Cited by 10 publications

(2 citation statements)

References 19 publications

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“…It has also been suggested that the presence of endotoxins, a systemic increase in bile component levels [9], and liver dysfunction [10] may lead to anorexia. Miyasaka et al [11] reported that patients with obstructive jaundice presented increased cholecystokinin (CCK) concentrations. This hormone has powerful anorectic properties [12][13][14] and has been shown in experimental studies to reduce food intake [15,16].…”

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confidence: 99%

Factors Predicting Nutritional Derangements in Patients with Obstructive Jaundice: Multivariate Analysis

et al. 2001

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Patients with obstructive jaundice (OJ) that requires surgery often have malnutrition associated with increased perioperative morbidity. This study investigated the factors influencing nutritional derangements in these patients. A series of 46 OJ patients were investigated prospectively (28 malignant tumors, 18 benign obstructions). A nutritional risk index of < 83.5 was used to define protein-calorie malnutrition. Liver function, cholecystokinin (CCK), tumor necrosis factor-alpha (TNFalpha), and endotoxin levels were determined. A multivariate analysis was performed, and an obstructive jaundice malnutrition index (OJMI) was obtained. Altogether, 22 (48%) OJ patients had malnutrition (33% with benign obstructions, 57% with malignant disease). Malnourished patients had higher serum bilirubin levels (258 +/- 120 vs. 154 +/- 62 mmol/L; p = 0.005), longer duration of jaundice (16 +/- 9 vs. 9 +/- 5 days; p = 0.03), and higher plasma levels of CCK (4.0 +/- 1.3 vs. 1.7 +/- 1.0 pmol/L; p = 0.005), alanine aminotransferase (ALT) (226 +/- 209 vs. 187 +/- 161 UI/L; p = 0.01), endotoxin (15 +/- 10 vs. 6.5 +/- 7.0 EU/L; p = 0.007), and TNFalpha (69 +/- 82 vs. 23 +/- 15 pg/ml; p = 0.008) than those without malnutrition. However, only serum bilirubin, CCK, ALT, and patient age were predictors for malnutrition by multivariate analysis. Malnutrition might be expected (95% confidence interval) in patients older than 68 years with increased bilirubin (> 290 mmol/L) and ALT (> 210 UI/L) levels that corresponded with an OJMI > 55. It was concluded that nutritional alterations in patients with obstructive jaundice were determined by the intensity of the biliary obstruction correlated with increased plasma CCK levels as well as with liver dysfunction and patient age.

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confidence: 99%

Factors Predicting Nutritional Derangements in Patients with Obstructive Jaundice: Multivariate Analysis

et al. 2001

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“…Plasma CCK levels were assayed by radioimmunoassay using OAL-656, '251-labeled Bolton-Hunter CCK-33 as a tracer and CCK-8 as a standard. The antiserum specifically reacted with the aminoterminal region of CCK-8, and bound 100% of both CCK-8 and CCK-33 and 85% of CCK-39, but did not cross-react with the nonsulfated form of CCK-8, gastrin 17-1, or cerulein (20). …”

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confidence: 94%

Mechanisms of Stimulatory Effect of Neuromedin C on Pancreatic Exocrine Secretion in Conscious Rats

Okubo

Miyasaka

Matsumoto³

et al. 1994

Pancreas

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The mechanisms of the stimulatory effect of the bombesin-like peptide neuromedin C on pancreatic exocrine secretion were examined in conscious rats. Rats were prepared with cannulae draining bile and pancreatic juice separately. Intravenous infusion of 0.35 nmoykg/h of neuromedin C significantly increased the secretions of pancreatic bicarbonate and protein, and transiently increased the plasma cholecystokinin (CCK) concentration. The increase in pancreatic secretion persisted for 90 min, whereas the increase in plasma CCK was observed only after 15 and 30 min from the beginning of neuromedin C infusion. Intravenous infusion of CR-1409, a specific CCK-receptor antagonist, inhibited, but did not abolish, the protein secretion stimulated by neuromedin C. Intraduodenal infusion of a potent proton pump inhibitor, omeprazole, suppressed, but did not abolish, protein secretion induced by neuromedin C. Omeprazole abolished the increase in bicarbonate secretion produced by neuromedin C. These results indicate that neuromedin C induces release of CCK and that its induction of pancreatic hypersecretion is due to both its direct effect and CCK. The results also suggest that gastric hypersecretion may have a role in the bicarbonate hypersecretion induced by neuromedin C.

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Role of endogenous bile on basal and postprandial CCK release in humans

1993

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The role of intraduodenal bile in regulation of plasma cholecystokinin (CCK) levels were investigated in patients with obstructive jaundice under external bile diversion and under physiological bile flow into the duodenum by internal bile drainage. Basal plasma CCK levels determined by a specific and sensitive bioassay in patients under external bile drainage (2.2 +/- 0.2 pmol/liter; mean +/- SE) were significantly higher than those in control subjects (1.0 +/- 0.3 pmol/liter). In control subjects, the peak CCK response (6.2 +/- 0.7 pmol/liter) to a test meal was seen at 45 min, whereas that in patients under external bile drainage, it was seen at 20 min after a test meal (17.6 +/- 3.2 pmol/liter; P < 0.01 vs controls). After peak response, plasma CCK levels in controls gradually decreased, but remained significantly elevated during a 3-hr observation period. In patients under bile diversion, the test meal caused a prompt plasma CCK peak, with a transient fall followed by a continuous rise until 180 min postprandially. In six patients, external bile diversion was changed to internal biliary drainage with a stent tube within two weeks to maintain physiological bile flow into the duodenum. Internal bile drainage normalized basal (0.9 +/- 0.2 pmol/liter) as well as meal-stimulated CCK release (peak value: 5.0 +/- 0.8 pmol/liter). These results demonstrate that endogenous bile exerts tonic inhibition on basal and postprandial plasma CCK levels in humans.

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Bile acids in human plasma interfere with cholecystokinin bioassay using dispersed pancreatic acini

Cited by 10 publications

References 19 publications

Factors Predicting Nutritional Derangements in Patients with Obstructive Jaundice: Multivariate Analysis

Factors Predicting Nutritional Derangements in Patients with Obstructive Jaundice: Multivariate Analysis

Mechanisms of Stimulatory Effect of Neuromedin C on Pancreatic Exocrine Secretion in Conscious Rats

Role of endogenous bile on basal and postprandial CCK release in humans

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