Changes of plasma levels of gastrointestinal peptides over the course of acute pancreatitis. Any significance for the pathophysiology and treatment of acute pancreatitis?
OBJECTIVE
Acute pancreatitis may be accompanied by alterations of the secretion of pancreatic and gastrointestinal peptides as a result of pancreatic inflammation. These changes, that may constitute targets of therapeutic manipulation, led to the study of the serum levels of various pancreatic and gastrointestinal peptides over the course of acute pancreatitis before and after the administration of octreotide and ranitidine.


METHODS
Concentrations of gastrin, glucagon, vasoactive intestinal peptide, neurotensin and pancreatic polypeptide were determined by radioimmunoassay in the plasma of 22 patients with acute pancreatitis on the first, sixth and 11th day of the disease. All patients were treated with octreotide s.c. while 14 of them were also administered ranitidine i.v. Treatment was initiated after taking the first blood sample.


RESULTS
Mean gastrin levels in patients receiving ranitidine was 56.76 ng/L and in patients not receiving ranitidine 47.16 ng/L on the first day (pNS) remaining stable throughout the course of acute pancreatitis. Mean glucagon, vasoactive intestinal peptide, neurotensin and pancreatic polypeptide levels on the first day were 52.05 pmol/L, 8.90 pmol/L, 9.80 pmol/L and 22.06 pmol/L, respectively, and no changes were found through the course of acute pancreatitis.


CONCLUSIONS
Plasma levels of gastrointestinal peptides remain constant over time and they are not significantly affected by the administration of octreotide or ranitidine. However more studies are necessary to document the significance of these findings.
Nikou
George C
GC
1st Department of Propedeutic Medicine, University of Athens, Medical School, Athens, Greece.
Giamarellos-Bourboulis
Evangelos J
EJ
Toumpanakis
Christos
C
Arnaoutis
Theodora P
TP
Kitsou
Efrosini
E
Kyriaki
Despina
D
Katsilambros
Nikolaos
N
D000208:Acute Disease; D000368:Aged; D005260:Female; D005755:Gastrins / Q000097:blood; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D005934:Glucagon / Q000097:blood; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009496:Neurotensin / Q000097:blood; D015282:Octreotide / Q000627:therapeutic use; D010191:Pancreatic Polypeptide / Q000097:blood; D010195:Pancreatitis / Q000097:blood* / Q000188:drug therapy / Q000503:physiopathology; D036361:Peptide Hormones / Q000097:blood*; D011899:Ranitidine / Q000627:therapeutic use; D014660:Vasoactive Intestinal Peptide / Q000097:blood
D005755:Gastrins; D005765:Gastrointestinal Agents; D006635:Histamine H2 Antagonists; D036361:Peptide Hormones; D014660:Vasoactive Intestinal Peptide; D009496:Neurotensin; D010191:Pancreatic Polypeptide; D011899:Ranitidine; D005934:Glucagon; D015282:Octreotide