Effects of morphine, enkephalins and naloxone on postprandial gastric acid secretion, gastric emptying and gastrin release in dogs

The effects of intravenous infusions of morphine, met-enkephalin and leu-enkephalin on gastric acid secretion, gastrin release and gastric emptying were investigated in four dogs with gastric cannulas stimulated by a liquid peptone meal. The actions of a potent opiate antagonist, naloxone, used alone or combined with opiates were also studied. Morphine, met-and leu-enkephalin decreased the fractional gastric emptying rate. Acid secretion was decreased by enkephalins and increased by high doses of morphine. Enkephalins and to a lesser degree morphine inhibited gastrin release during the first hour following the administration of the meal. Only leu-enkephalin decreases significantly the integrated gastrin response. Naloxone at the doses used antagonized partly or totally the effects of opiates on gastric emptying but not those on gastric secretion or gastrin release. Naloxone infused alone had no significant effect on the gastric functions tested. These studies indicate that in dogs stimulated by a liquid test meal, enkephalins inhibit gastric emptying, acid secretion and gastrin release. Morphine inhibits gastric emptying and gastrin release and enhances acid secretion.     

The glucagon-like peptide-1 metabolite GLP-1-(9-36) amide reduces postprandial glycemia independently of gastric emptying and insulin secretion in humans

Glucagon-like peptide 1 (GLP-1) lowers glycemia by modulating gastric emptying and endocrine pancreatic secretion. Rapidly after its secretion, GLP-1-(7-36) amide is degraded to the metabolite GLP-1-(9-36) amide. The effects of GLP-1-(9-36) amide in humans are less well characterized. Fourteen healthy volunteers were studied with intravenous infusion of GLP-1-(7-36) amide, GLP-1-(9-36) amide, or placebo over 390 min. After 30 min, a solid test meal was served, and gastric emptying was assessed. Blood was drawn for GLP-1 (total and intact), glucose, insulin, C-peptide, and glucagon measurements. Administration of GLP-1-(7-36) amide and GLP-1-(9-36) amide significantly raised total GLP-1 plasma levels. Plasma concentrations of intact GLP-1 increased to 21 +/- 5 pmol/l during the infusion of GLP-1-(7-36) amide but remained unchanged during GLP-1-(9-36) amide infusion [5 +/- 3 pmol/l; P < 0.001 vs. GLP-1-(7-36) amide administration]. GLP-1-(7-36) amide reduced fasting and postprandial glucose concentrations (P < 0.001) and delayed gastric emptying (P < 0.001). The GLP-1 metabolite had no influence on insulin or C-peptide concentrations. Glucagon levels were lowered by GLP-1-(7-36) amide but not by GLP-1-(9-36) amide. However, the postprandial rise in glycemia was reduced significantly (by approximately 6 mg/dl) by GLP-1-(9-36) amide (P < 0.05). In contrast, gastric emptying was completely unaffected by the GLP-1 metabolite. The GLP-1 metabolite lowers postprandial glycemia independently of changes in insulin and glucagon secretion or in the rate of gastric emptying. Most likely, this is because of direct effects on glucose disposal. However, the glucose-lowering potential of GLP-1-(9-36) amide appears to be small compared with that of intact GLP-1-(7-36) amide.     

Stimulatory effect of endogenous orexin A on gastric emptying and acid secretion independent of gastrin

Orexin A (OXA) increases food intake and inhibits fasting small bowel motility in rats. The aim of this study was to examine the effect of exogenous OXA and endogenous OXA on gastric emptying, acid secretion, glucose metabolism and distribution of orexin immunoreactivity in the stomach. Rats equipped with a gastric fistula were subjected to intravenous (IV) infusion of OXA or the selective orexin-1 receptor (OX1R) antagonist SB-334867-A during saline or pentagastrin infusion. Gastric emptying was studied with a liquid non-nutrient or nutrient, using 51Cr as radioactive marker. Gastric retention was measured after a 20-min infusion of OXA or SB-334867-A. Plasma concentrations of OXA, insulin, glucagon, glucose and gastrin were studied. Immunohistochemistry against OXA, OX1R and gastrin in gastric tissue was performed. OXA alone had no effect on either acid secretion or gastric emptying. SB-334867-A inhibited both basal and pentagastrin-induced gastric acid secretion and increased gastric retention of the liquid nutrient, but not PEG 4000. Plasma gastrin levels were unchanged by IV OXA or SB-334867-A. Plasma OXA levels decreased after intake of the nutrient meal and infusion of the OX1R antagonist. Only weak effects were seen on plasma glucose and insulin by OXA. Immunoreactivity to OXA and OX1R were found in the mucosa, myenteric cells bodies and varicose nerve fibers in ganglia and circular muscle of the stomach. In conclusion, endogenous OXA influences gastric emptying of a nutrient liquid and gastric acid secretion independent of gastrin. This indicates a role for endogenous OXA, not only in metabolic homeostasis, but also in the pre-absorptive processing of nutrients in the gut.     

Corticotropin-releasing factor inhibits gastric emptying in dogs: Studies on its mechanism of action

The effects of corticotropin-releasing factor (CRF) on gastric emptying of a saline solution was further investigated in six dogs prepared with gastric fistulas and chronic cerebroventricular guides and in four other dogs with chronic gastric fistulas and pancreatic (Herrera) cannulas. Intravenous infusion of CRF significantly inhibited gastric emptying whereas intracerebroventricular injection of CRF had no effect. Pharmacologic blockade of β-adrenergic system by propranolol did not modify intravenous CRF induced delay in gastric emptying. Intravenous CRF did not influence basal pancreatic secretion whereas secretin infused stimulated bicarbonate secretion. These results indicate that intravenous but not intracerebroventricular administration of CRF inhibited gastric emptying of a saline solution in dogs. The inhibitory effect of intravenous CRF on gastric emptying is not mediated by the β-adrenergic nervous system, and not secondary to the release of other peptides that affect both pancreatic secretion and gastric emptying such as cholecystokinin and peptide YY.     

Ghrelin stimulates gastric emptying but is without effect on acid secretion and gastric endocrine cells

Ghrelin, a recently discovered peptide hormone, is produced by endocrine cells in the stomach, the so-called A-like cells. Ghrelin binds to the growth hormone (GH) secretagogue receptor and releases GH. It is claimed to be orexigenic and to control gastric acid secretion and gastric motility. In this study, we examined the effects of ghrelin, des-Gln¹⁴-ghrelin, des-octanoyl ghrelin, ghrelin-18, -10 and -5 (and motilin) on gastric emptying in mice and on gastric acid secretion in chronic fistula rats and pylorus-ligated rats. We also examined whether ghrelin affected the activity of the predominant gastric endocrine cell populations, G cells, ECL cells and D cells. Ghrelin and des-Gln¹⁴-ghrelin stimulated gastric emptying in a dose-dependent manner while des-octanoyl ghrelin and motilin were without effect. The C-terminally truncated ghrelin fragments were effective but much less potent than ghrelin itself. Ghrelin, des-Gln¹⁴-ghrelin and des-octanoyl ghrelin neither stimulated nor inhibited gastric acid secretion, and ghrelin, finally, did not affect secretion from either G cells, ECL cells or D cells.     

Dose-response for inhibition by amylin of cholecystokinin-stimulated secretion of amylase and lipase in rats

BACKGROUND AND AIMS: The neuroendocrine hormone amylin, cosecreted with insulin from pancreatic beta-cells in response to nutrient ingestion, has several physiologic actions to limit the rate of nutrient uptake, including the slowing of gastric emptying. METHODS: To investigate whether amylin might modulate digestive enzyme secretion from the exocrine pancreas, anesthetized Sprague Dawley rats were cannulated via the pancreatic duct and the secretory response (flow, amylase and lipase) to cholecystokinin (1 microg s.c.) was measured in the absence and in the presence of 0.1, 0.3 and 1 microg s.c. doses of amylin. RESULTS: Amylin alone did not affect pancreatic secretion, but it dose-dependently inhibited cholecystokinin-stimulated amylase secretion by up to 58% and lipase secretion by up to 67%. The ED50's for these responses were 0.21 microg+/-0.18 log and 0.11 microg+/-0.05 log, respectively, doses that result in excursions of plasma amylin concentration that are within the reported physiological range. Amylin did not evoke cell signalling in the Ar42j model of pancreatic acinar cells, and responses to amylin were not observed in either Ar42j cells or isolated pancreatic acini in a microphysiometer indicating that the effect of amylin was indirect. CONCLUSIONS: Inhibition of stimulated pancreatic enzyme secretion is likely to be a physiological, extrapancreatic, action of amylin. Amylinergic mechanisms modulating both gastric emptying and pancreatic enzyme secretion may thus match, respectively, the appearance of substrate and enzymes in the gut lumen.     

Central nervous system action of TRH to stimulate gastric emptying in rats

The effects of intracisternal injection of TRH on gastric emptying of a liquid meal was investigated in 24 h fasted rats using the phenol red method. Intracisternal injection of TRH, RX 77368, or [N-Val2]-TRH, an analog devoid of TSH-releasing activity, 5 min prior to a meal, stimulated gastric emptying measured 20 min later. TRH action was dose dependent (1-100 ng), and rapid in onset. The calculated time for emptying half of the meal was decreased from 16 +/- 3 min (control group) to 4 +/- 1 min (TRH 30 ng). The stable analog, RX 77368, unlike TRH, stimulated gastric emptying when the meal was given 60 min after peptide injection. Intravenous injection of atropine (2.5 micrograms) inhibited and that of carbachol (1 microgram) stimulated gastric emptying whereas i.v. injection of TRH (0.1-1 microgram) had no effect. Vagotomy but not adrenalectomy reversed the increase in gastric emptying induced by intracisternal TRH. Atropine blocked the stimulatory effect of TRH and carbachol. These results demonstrate that TRH acts within the brain to stimulate gastric emptying through vagus-dependent and cholinergic pathways whereas alterations of adrenal and pituitary-thyroid secretion do not play an important role.     

Gastric emptying during exercise: effects of heat stress and hypohydration

To determine the effects of acute heat stress, heat acclimation and hypohydration on the gastric emptying rate of water (W) during treadmill exercise, ten physically fit men ingested 400 ml of W before each of three 15 min bouts of exercise (treadmill, approximately 50% VO2max) on five separate occasions. Stomach contents were aspirated after each exercise bout. Before heat acclimation (ACC), experiments were performed in a neutral (18 degrees C), hot (49 degrees C) and warm (35 degrees C) environment. Subjects were euhydrated for all experiments before ACC. After ACC, the subjects completed two more experiments in the warm (35 degrees C) environment; one while euhydrated and a final one while hypohydrated (-5% of body weight). The volume of ingested water emptied into the intestines at the completion of each exercise bout was inversely correlated (P less than 0.01) with the rectal temperature (r = -0.76). The following new observations were made: 1) exercise in a hot (49 degrees C) environment impairs gastric emptying rate as compared with a neutral (18 degrees C) environment, 2) exercise in a warm (35 degrees C) environment does not significantly reduce gastric emptying before or after heat acclimation, but 3) exercise in a warm environment (35 degrees C) when hypohydrated reduces gastric emptying rate and stomach secretions. Reductions in gastric emptying appear to be related to the severity of the thermal strain induced by an exercise/heat stress.     

Free amino acids in basal and vagally stimulated gastric secretion

The concentrations of the individual free amino acids were determined in one hour fraction of basal secretion and peak hydrogen ion secretion following stimulation with 2-deoxy-D-glucose (2-DG) (group I) or insulin (group II). Group I consisted of 9 patients with duodenal ulcer having hypersecretion of gastric acid as determined by histamine test; 7 patients with duodenal ulcer who underwent truncal vagotomy and had insulin test performed two weeks after the operation formed group II. The total concentration of free amino acids was similar in basal and in stimulated gastric juice in both groups. Also the concentrations of the individual amino acids did not change significantly after stimulation. There was, however, a significant increase following stimulation in the output of amino acids both in group I and in group II. This increase was parallel to that in the volume of gastric juice, which suggests that a definite amount of free amino acids is always present in the gastric juice, and that the secretion of these acids is not under vagal control.     

Inhibition of pepsinogen secretion in isolated gastric glands by amphotericin B is secretagogue specific

Pepsinogen secretion from isolated gastric glands, stimulated by 8-bromoadenosine 3',5'-cyclic monophosphate (8BrcAMP), forskolin, or cholecystokinin octapeptide, was inhibited by the presence of amphotericin B in the incubation medium. However, amphotericin had no effect, or only a slight effect (less than 10% inhibition), on pepsinogen secretion stimulated by crude secretin. Incubation of glands with either of the mitochondrial inhibitors, rotenone or carbonyl cyanide m-chlorophenylhydrazone, reduced pepsinogen secretory responses both to 8BrcAMP and to crude secretin. This suggests that amphotericin inhibition, which is secretagogue specific, was not the result of a general metabolic inhibition. Amphotericin caused an increase in sodium and chloride content and a decrease in potassium content of glands. Experiments in which the medium content of either sodium, potassium, or chloride was varied, suggested that part of the amphotericin inhibition could be attributed to a rise in intracellular chloride content. Results did not support the involvement of changes in intracellular sodium or potassium content in the inhibitory mechanism of amphotericin. It was concluded that amphotericin caused a rapid and secretagogue-specific inhibition of pepsinogen secretion in isolated gastric glands, and that the mechanism of inhibition may, to some extent, involve changes in intracellular chloride content.     

GIP and GLP-1 as incretin hormones: lessons from single and double incretin receptor knockout mice

Glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) are gut-derived incretins secreted in response to nutrient ingestion. Both incretins potentiate glucose-dependent insulin secretion and enhance beta-cell mass through regulation of beta-cell proliferation, neogenesis and apoptosis. In contrast, GLP-1, but not GIP, inhibits gastric emptying, glucagon secretion, and food intake. Furthermore, human subjects with Type 2 diabetes exhibit relative resistance to the actions of GIP, but not GLP-1R agonists. The physiological importance of both incretins has been investigated through generation and analysis of incretin receptor knockout mice. Elimination of incretin receptor action in GIPR-/- or GLP-1R-/- mice produces only modest impairment in glucose homeostasis. Similarly, double incretin receptor knockout (DIRKO) mice exhibit normal body weight and normal levels of plasma glucagon and hypoglycemic responses to exogenous insulin. However, glucose-stimulated insulin secretion is significantly decreased following oral but not intraperitoneal glucose challenge in DIRKO mice and the glucose lowering actions of dipeptidyl peptidase-IV (DPP-IV) inhibitors are extinguished in DIRKO mice. Hence, incretin receptor signaling exerts physiologically relevant actions critical for glucose homeostasis, and represents a pharmacologically attractive target for development of agents for the treatment of Type 2 diabetes.     

Effects of cholecystokinin, secretin, and pancreatic polypeptide on secretion of gastric inhibitory polypeptide, insulin, and glucagon

Although the capacity of food components to cause more insulin secretion when given orally than when given intravenously is related significantly to increased plasma concentration of gastric inhibitory polypeptide (GIP), stimulated only by the oral route, questions arise as to what extent other gastrointestinal hormones modify insulin secretion either directly or by influencing the secretion of GIP. The triacontatriapeptide form of cholecystokinin (CCK₃₃), infused in dose gradients intravenously in dogs increases insulin secretion, and comparably to equimolar doses of the carboxy-terminal octapeptide of cholecystokin (CCK₈); neither compound changes fasting plasma levels of GIP or glucose. Glucagon was increased only by the largest dose of CCK₈ (0.27 ug/kg). Unlike the situation with GIP, it is not necessary to increase the plasma glucose above fasting level to obtain the insulin-releasing action of CCK. When glucose is infused intravenously (2 g in 0.5 min) at the beginning of a 15-minute infusion of CCK₈ (10 ng/kg/min), the amount of insulin release is greater than is produced by CCK₈ or glucose alone. In the same type of experiment, the infusion of GIP, in equimolar amounts as CCK₈, plus glucose causes no more insulin secretion than is stimulated by glucose alone. Secretin has only a small stimulating action on insulin release, and pancreatic polypeptide (PP) has no effect. Neither secretin nor PP affects GIP secretion, whether either is given alone, or together, or with CCK₈. Either secretin or CCK₈ inhibits oral glucose-stimulated increase in plasma GIP. These inhibitory effects are probably very much related to the hormone-induced decrease in gastric emptying, but changes in somatostatin secretion and other hormones possibly exert contributory actions. In conclusion, GIP in certain dose ranges has been reported to cause major increase in insulin secretion, but we showed that the insulin-releasing action of a small dose of glucose (2 g) infused intravenously was not augmented by GIP (44.5 ng/kg/min), although it was significantly increased by an equimolar dose of CCK₈. When plasma glucose was maintained at a fasting level, gradient equimolar dosages of CCK₈ and CCK₃₃ had comparable insulin-releasing action; GIP had no effect.     

Effect of peripherally administered ghrelin on gastric emptying and acid secretion in the rat

Ghrelin is a gut peptide that is secreted from the stomach and stimulates food intake. There are ghrelin receptors throughout the gut and intracerebroventricular ghrelin has been shown to increase gastric acid secretion. The aim of the present study was to examine the effects of peripherally administered ghrelin on gastric emptying of a non-nutrient and nutrient liquid, as well as, basal and pentagastrin-stimulated gastric acid secretion in awake rats. In addition, gastric contractility was studied in vitro. Rats equipped with a gastric fistula were subjected to an intravenous infusion of ghrelin (10-500 pmol kg(-1) min(-1)) during saline or pentagastrin (90 pmol kg(-1) min(-1)) infusion. After administration of polyethylene glycol (PEG) 4000 with 51Cr as radioactive marker, or a liquid nutrient with (51)Cr, gastric retention was measured after a 20-min infusion of ghrelin (500 pmol kg(-1) min(-1)). In vitro isometric contractions of segments of rat gastric fundus were studied (10(-9) to 10(-6) M). Ghrelin had no effect on basal acid secretion, but at 500 pmol kg(-1) min(-1) ghrelin significantly decreased pentagastrin-stimulated acid secretion. Ghrelin had no effect on gastric emptying of the nutrient liquid, but significantly increased gastric emptying of the non-nutrient liquid. Ghrelin contracted fundus muscle strips dose-dependently (pD2 of 6.93+/-0.7). Ghrelin IV decreased plasma orexin A concentrations and increased plasma somatostatin concentrations. Plasma gastrin concentrations were unchanged during ghrelin infusion. Thus, ghrelin seems to not only effect food intake but also gastric motor and secretory function indicating a multifunctional role for ghrelin in energy homeostasis.     

Disturbed gastric motility and pancreatic hormone release in diabetes mellitus.

BACKGROUND AND AIMS: The influence of glucose metabolism and postprandial release of glucagon on gastric emptying in diabetes mellitus is still unclear. The aim of this study was to assess the relationship between glucose, insulin and glucagon and alterations of gastric motility in symptomatic diabetic subjects with delayed gastric emptying. METHODS: Scintigraphy for solids and liquids, 13C-acetate breath test, electrogastrography and antral manometry were assessed in 20 symptomatic subjects with diabetes mellitus type II and in 20 healthy controls. Simultaneously, serum glucose, glucagon and insulin levels were determined during the functional studies. RESULTS: Postprandial increase in antral motility and myoelectrical activity were seen in controls, but were missing in the group with diabetes mellitus. Moreover, in the fasting state the dominant frequency instability coefficient observed in healthy individuals and in subjects with diabetes of short (<5 years) duration was significantly reduced in subjects with longer duration of diabetes while the postprandial increase in dominant frequency instability coefficient was missing in all diabetics. Following the standard test meal, serum glucose and plasma glucagon in the diabetics increased to a significantly higher degree when compared to controls. CONCLUSIONS: Symptomatic subjects with delayed gastric emptying present abnormal patterns of gastric motor and electrical activity. Higher than normal postprandial plasma levels of glucagon may, at least in part, be responsible for disturbed gastric motility in non-insulin-dependent diabetic subjects.     

Experimental neurosis and gastric secretion in dogs

In four dogs (2 males and 2 females from one litter) with established gastric cannula gastric secretion was studied in control experiments and in induced experimental neurosis. Gastric secretion was stimulated by insulin. We monitored in individual 15 min. portions the amount of gastric juice, total HCl output, output of acid gastric proteinases, mucoproteins and some ions. The gastric juice was dialyzed and freeze dried. 50 mg of the lyophilisate was separated on Sephadex G 100. Macromolecular substances were fractionated into glycoproteins (peak I), acid gastric proteinases (peak II) and glycopeptides and polypeptides (peak III). The ratio of these individual macromolecular substances remainded constant in the same dog in all control experiments. However, there were significant differences between individual animals. Induction of experimental neurosis (by collision of the alimentary and avoidance reflex) gave rise to changes not only in the output of HCl and gastric proteinases, but also in the ratio of macromolecular substances. In the series of observed parameters these changes were of a different nature in males and females.     

Effect of chlorpromazine on ulcer formation by indomethacin in histamine- and insulin-stimulated rats.

The effect of chlorpromazine on ulcer formation by indomethacin and on total gastric secretion and gastric acid secretion was studied in rats. Secretion and ulceration were evaluated under basal conditions and after the administration of histamine or insulin, i.e. substances stimulating gastric acid secretion. The authors confirmed that chlorpromazine inhibits basal secretion and found that it also inhibits histamine- and insulin-stimulated gastric secretion, in correlation to the dose. It also strongly inhibits the formation of stomach lesions caused by indomethacin under basal conditions and after pretreatment with histamine (3 and 10 mg/kg) and insulin (0.3 IU/kg). Chlorpromazine did not inhibit lesions formed after combining indomethacin with insulin in a dose of 3 IU/kg. The results show that although chlorpromazine inhibits both basal and centrally or peripherally stimulated gastric secretion, its effect on stomach lesions caused by indomethacin is not uniform. Pretreatment with insulin in a dose of 3 IU/kg demonstrates that indomethacin-induced stomach lesions are markedly potentiated by this dose of insulin and are not dependent on gastric secretion only. The inability of chlorpromazine to inhibit these lesions gives the evidence that other--probably central--mechanisms play a role in their development.     

下丘脑室旁核orexin-A对大鼠摄食和胃动力影响及调控机制

目的:探讨下丘脑室旁核orexin-A对大鼠摄食和胃动力影响及调控机制。方法:采用免疫组化观察下丘脑室旁核(paraventricular nucleus,PVN)orexin受体表达情况;PVN注射orexin-A观察大鼠摄食、胃运动、胃酸分泌和胃排空的改变。结果:免疫组化实验显示大鼠PVN中存在orexin受体免疫阳性细胞。PVN注射orexin-A后,大鼠前三小时摄食增加,6 h和24 h摄食无显著改变。PVN微量注射orexin-A后,大鼠胃运动幅度和频率增加、胃排空增快并且胃酸分泌增多。[D-Lys-3]-GHRP-6可部分阻断orexin-A对摄食、胃运动、胃排空和胃酸分泌的促进作用,SB334867可完全阻断orexin-A对胃运动、胃排空和胃酸分泌的促进作用。结论:下丘脑室旁核orexin-A可能通过生长激素促泌素GHSR受体信号通路调控大鼠摄食及胃功能。     

The role of vagal integrity in gastrin releasing peptide stimulated gastroenteropancreatic hormone release and gastric acid secretion

The role of the vagus nerve in the control of gastrin releasing peptide (GRP) stimulated gastroenteropancreatic hormone release and gastric acid secretion was investigated in four conscious gastric fistula dogs using a technique of bilateral cryogenic vagal blockade. A 90-min infusion of GRP at a dose of 400 pmol X kg-1. h-1 produced significant elevations in plasma levels of gastrin, motilin, GIP, enteroglucagon, insulin, pancreatic glucagon, pancreatic polypeptide and VIP. Vagal blockade reversibly inhibited the rise of plasma PP and significantly blunted the elevation of plasma VIP. However, the GRP stimulated response of the other hormones investigated was not modified by vagal blockade. Similarly, the substantial secretion of gastric acid observed with GRP was not influenced by vagal blockade. Thus GRP acts predominantly via mechanisms which are independent of vagal integrity, findings that are in support of a major role for the local neuromodulation of hormone release and gastric acid secretion.     

The role of secretin in the control of gastric secretion and emptying in the dog

It is well established that duodenal acidification strongly inhibits gastric acid secretion, gastric emptying rate and gastrin release. These effects are at least partly mediated via hormonal pathways, but it is not known whether they are mediated by the release of one peptide named in the past enterogastrone, or by several peptides acting together. The effects of duodenal acidification on gastric acid secretion and gastrin release can be reproduced by infusion of small doses of secretin and plasma secretin levels increase during duodenal acidification or after a meal. This peptide is thus the most probable candidate as an enterogastrone. It has however never been clearly shown that administration of low doses of secretin do decrease gastric emptying rate as well as acid secretion. Experiments were performed on four dogs with gastric fistulas. A peptone solution was infused into the stomach. The experiments were repeated during infusion of synthetic secretin. Our results indicate that infusion of low doses of secretin reproduce all the effects of duodenal acidification: a significant inhibition of gastric acid secretion, gastrin release and gastric emptying rate.     

Initially more rapid small intestinal glucose delivery increases plasma insulin, GIP, and GLP-1 but does not improve overall glycemia in healthy subjects

The rate of gastric emptying of glucose-containing liquids is a major determinant of postprandial glycemia. The latter is also dependent on stimulation of insulin secretion by glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1). Although overall emptying of glucose approximates 1-3 kcal/min, the "early phase" of gastric emptying is usually more rapid. We have evaluated the hypothesis that increased stimulation of incretin hormones and insulin by a more rapid initial rate of small intestinal glucose delivery would reduce the overall glycemic response to a standardized enteral glucose load. Twelve healthy subjects were studied on two separate days in which they received an intraduodenal (id) glucose infusion for 120 min. On one day, the infusion rate was variable, being more rapid (6 kcal/min) between t = 0 and 10 min and slower (0.55 kcal/min) between t = 10 and 120 min, whereas on the other day the rate was constant (1 kcal/min) from t = 0-120 min, i.e., on both days 120 kcal were given. Between t = 0 and 75 min, plasma insulin, GIP, and GLP-1 were higher with the variable infusion. Despite the increase in insulin and incretin hormones, blood glucose levels were also higher. Between t = 75 and 180 min, blood glucose and plasma insulin were lower with the variable infusion. There was no difference in the area under the curve 0-180 min for blood glucose. We conclude that stimulation of incretin hormone and insulin release by a more rapid initial rate of id glucose delivery does not lead to an overall reduction in glycemia in healthy subjects.