UNRESPONSIVENESS OF INSULINOMA CELLS TO SECRETIN - SIGNIFICANCE OF THE SECRETIN TEST IN PATIENTS WITH INSULINOMA

被引：21

作者：

IMAMURA, M

HATTORI, Y

NISHIDA, O

HONDA, T

SHIMADA, Y

MIYAHARA, T

WAGATA, T

BABA, N

TOBE, T

机构：

[1] Departments of Surgery, Kyoto University, Kyoto

[2] Geriatric Medicine, Kyoto University, Kyoto

[3] Nuclear Medicine, Kyoto University, Kyoto

来源：

PANCREAS | 1990年 / 5卷 / 04期

关键词：

Insulinoma cells; Insulinoma patients; Pancreatic; β; cells; Secretin; Secretin test;

D O I：

10.1097/00006676-199007000-00015

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

It is well known that B cells in the pancreas release insulin when stimulated by secretin, but there have been few reports on the response of insulinoma cells to secretin. In five patients with insulinoma, changes in serum immunoreactive insulin (IRI) concentration were measured after the intravenous injection of secretin into the peripheral vein before and after extirpation of the insulinoma. The extirpated insulinomas were cultured and tested for their response to secretin. The rise in serum IRI in response to secretin in patients with insulinoma was significantly slower and smaller than in normal volunteers. After removal of the insulinoma, the response to secretin became prompt and increased with time. Cultured insulinoma cells did not release insulin when stimulated by secretin. Therefore, it is concluded that the response of insulinoma cells to secretin is quite different from that of normal 13 cells, and that the function of β cells in the insulinoma-bearing pancreas is suppressed by the autonomous hypersecretion of insulin by the insulinoma. The extent of the decrease in function of the β cells in patients with insulinoma can be estimated by the intravenous secretin test. Thus, the secretin test is sometimes useful in the differentiation of hypoglycemia due to insulinoma from that due to β cell hyperplasia or alimentary hyperinsulinemia. © 1990 Raven Press Ltd., New York.

引用

页码：467 / 473

页数：7

共 13 条

[1]

Lerner R.L., Porte D., Uniphasic insulin responses to secretin stimulation in man, J Clin Invest, 49, pp. 2276-2280, (1970)

[2]

Kraegen E.W., Chisholm D.J., Young J.D., Lazrus L., The gastrointestinal stimulus to insulin release II. A dual action of secretin, J Clin Invest, 49, pp. 524-529, (1970)

[3]

Jensen S.L., Fahrenkrug J., Hoist J.J., Kuhl C., Nielsen O.V., Juckadell O., Secretory effects of secretin on isolated perfused porcine pancreas, Am J Physiol, 235, pp. E381-E386, (1978)

[4]

Tachibana S., Secretin and cholecystokinin-pancreozymin, their bioassay and purification, Gastro-Entero-Pancreatic Endocrine System, pp. 174-192, (1973)

[5]

Porte D., Pupo A.A., Insulin responses to glucose: Evidence for a two pool system in man, J Clin Invest, 48, pp. 2309-2319, (1969)

[6]

Otsuki M., Sakamoto C., Ohki A., Yuu H., Morita S., Baba S., Effects of porcine secretin on exocrine and endocrine function in the isolated perfused rat pancreas, Am J Physiol, 241, pp. G43-G48, (1981)

[7]

Imamura M., Takahashi K., Adachi H., Et al., Usefulness of selective arterial secretin injection test for localization of gastrinoma in the Zollinger-Ellison syndrome, Ann Surg, 205, pp. 230-239, (1987)

[8]

McGuigan J.E., Wolfe M.M., Secretin injection test in the diagnosis of gastrinoma, Gastroenterology, 79, pp. 1324-1331, (1980)

[9]

Feldman M., Schiller L.R., Walsh J.H., Fordtran J.S., Richardson C.T., Positive intravenous secretin test in patients with achlorhydria-related hypergastrinemia, Gastroenterology, 93, pp. 59-62, (1987)

[10]

Hixson L.J., Morgan T.R., Sampliner R.E., False-positive se-cretin-KABI provocation test associated with achlorhydria, J Clin Gastroenterol, 10, pp. 201-204, (1988)

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