Molecular forms of gastrin in the circulation of patients with achlorhydria.
OBJECTIVE
To study circulating gastrin profile, both fasting and postprandially, in patients with achlorhydria due to auto-immune atrophic gastritis, comparing these with normal healthy controls.


METHODS
Circulating gastrins were measured using three region-specific radio-immunoassays: amidated gastrins (R98), N-terminal G34 (R526) and N-terminal G17 (GP168). Samples were analysed further using gel chromatography.


RESULTS
Fasting gastrin concentrations were elevated in achlorhydria as measured using all three antisera: median 714 pmol/l (range 107-5176) in achlorhydria versus 12 pmol/l (2-33) in controls (R98), 343 pmol/l (45-4316) versus 10 pmol/l (5-41) (R526), and 720 pmol/l (14-6000) versus 2 pmol/l (1-10) (GP168). In patients, 47% of gastrin was amidated (95% in controls) and 30% was processed N-terminally only to G71 (4% in controls). Gastrin rose significantly postprandially: 1643 pmol/l (269-7142) in patients versus 24 pmol/l (5-142) in controls (R98), 432 pmol/l (113-4756) versus 15 pmol/l (7-45) (R526) and 2189 pmol/l (304-7150) versus 15 pmol/l (7-45) (GP168). Only 25% was amidated in the patient group (93.5% in controls) and 21% remained as component I (4% in controls).


CONCLUSIONS
This abnormal gastrin profile associated with hypergastrinaemia secondary to achlorhydria is consistent with saturation of the enzymes involved in the processing of the pro-hormone, in particular amidation of the C-terminus.
Department of Medicine, Royal Hospitals Trust and The Queen's University of Belfast, UK.
J E
JE
Ardill
S
S
Banerjee
A
A
Beattie
D
D
Fillmore
A
A
El Nujumi
K E
KE
McColl
D000126:Achlorhydria / Q000097:blood*; D000368:Aged; D000369:Aged, 80 and over; D002850:Chromatography, Gel; D005215:Fasting / Q000097:blood; D005260:Female; D005755:Gastrins / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019518:Postprandial Period; D011863:Radioimmunoassay / Q000379:methods
D005755:Gastrins