The Electrolyte and Protein Contents and Outputs in Duodenal Juice After Pancreozymin and Secretin Stimulation in Normal Children and in Patients Ith Cystic FIBROSIS.1

Abstract

SUMMARY The total pancreatic outputs and the secretion rates of fluid volume, protein, bicarbonate, sodium, potassium, calcium and magnesium were studied after pancreozymin and secretin stimulation in 12 control children and in 5 patients with cystic fibrosis of the pancreas (CF). Duodenal contents were collected through a double‐balloon, triple‐lumen rubber tube, thus avoiding contamination by gastric juce and distal losses. In CF patients, compared to the normal controls, decreased outputs of fluid volume, protein and electrolytes were found. Secretion rates, calculated per kg body weight and per min of fluid volume protein and electrolytes were analyzed separately for the post‐pancreozymin and the post‐secretin periods. In control children the secretion rates of sodium aad bicarbonate were higher after secretin stimulation, whereas those of protein, calcium, and magnesium were higher after pancreozymin stimulation; secretion rates of fluid volume and potassium did not show any significant difference. In CF patients the secretion rates of sodium, potassium and magnesium were more reduced after secretin whereas those of calcium and protein are more reduced after pancreozymin; the secretion rates of fluid volume and bicarbonate are similarly reduced after both hormonal stimulation. The possible role of a disturbance of the tubular and the acinar secretion of the pancreas in the pathogenesis of cystic fibrosis is discussed.

The Development of Specific Responses of the Exocrine Pancreas to Pancreozymin and Secretin Stimulation in Newborn Infants

“…The hormones used were pancreozymin and secretin Boots given in a dosage of 2 I.U./kg, body wt. Duodenal fluid, protein, Na+, K+, Ca++, and HCO S~ were determined as in previous studies [9,10]. The results are expressed as secretion rates per kilogram of body weight per minute before and after each single hormonal stimulation.…”

“…In a previous study on the pancreatic production of protein and electrolytes in infants and children we demonstrated [10] that in healthy study subjects aged between 9 months and 13 years the secretion rates of sodium and bicarbonate are higher after secretin stimulation, those of calcium, magnesium and protein are higher after pancreozymin and those of duodenal fluid and potassium are practically the same after stimulation by each of the two hormones. It therefore appears that, as in adults [2,7], the exocrine pancreas responds specifically to pancreozymin and secretin in healthy infants and children [10].…”

“…It therefore appears that, as in adults [2,7], the exocrine pancreas responds specifically to pancreozymin and secretin in healthy infants and children [10]. Whether the time of onset of this specific response to hormonal stimulation is at birth or some time after birth was then not investigated and is at that time obscure.…”

Exocrine Pancreas Function in Premature and Full Term Neonates

“…We started sampling only if the duodenum was completely isolated from the stomach and the jejunum, i.e., if 4-5 ml air introduced into the lumen could be completely recovered. After an initial collection of duodenal juice for 10-20 min, exocrine pancreas secretion was stimulated, as in our previous investigations [9,22,23], with pancreozymin [25] and 20 min later with secretin [25]. Both hormones were administered by slow intravenous injection (1 min).…”

“…For evaluation of the degree of maturity of exocrine pancreatic function in premature and full term neonates, we used the values obtained previously for older infants and children who were 3 months to 13 years of age [23].…”