GLUCAGON DEFICIENCY AND HYPERAMINOACIDEMIA AFTER TOTAL PANCREATECTOMY
GLUCAGON DEFICIENCY AND HYPERAMINOACIDEMIA AFTER TOTAL PANCREATECTOMY
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DOI：
10.1172/jci109717
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发表时间：
1980-01-01
影响因子：
15.9
通讯作者：
OWEN, OE
中科院分区：
文献类型：
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作者：
BODEN, G;MASTER, RW;OWEN, OE
这项研究的第一个目标是调查全胰腺切除患者是否存在胰高血糖素[G]缺乏，如果是，程度如何。9例胰腺切除患者外周血浆中免疫反应性高血糖素(IRG)浓度与10例正常对照组相比无显著差异。用2份抗血清(30-K和RCS-5)和1份抗血清(RCS-5)检测了该分子的COOH末端部分，并推测RCS-5是胰腺G的特异性抗体。使用30-K，80.8。+-。9%的IRG在空洞体积内洗脱。该物质在Sephadex G-200上重新层析，其表观相对分子质量为.apprx。20万。只有18.3。+-。9%在IRG3500区域洗脱。与正常对照组相比，胰腺切除患者的IRG3500显著降低(49。+-。9对18+-。9pg/ml，P<0.05)。使用RCS-5，所有IRG(对应于20。+-。6pg/ml血浆)在IRG3500区洗脱。本研究的第二个目标是研究慢性G缺乏症对血浆氨基酸的影响。在所研究的9例胰腺切除患者中，吸收后血浆丝氨酸、丙氨酸、精氨酸、甘氨酸、苏氨酸、瓜氨酸、α-氨基丁酸和酪氨酸浓度显著高于20名正常对照组。2例胰腺切除患者应用G输注(分别为6.25和8.0微克/小时)产生的生理性G增量使高氨基酸血症在22小时内恢复正常。胰腺切除患者明显存在部分G缺乏，这是由于基础G分泌减少和刺激G分泌减少所致；胰腺切除患者某些生糖氨基酸浓度升高可能是由于肝糖异生减少所致；RCS-5抗血清不是胰腺G特异性的。
The first goal of this study was to investigate whether totally pancreatectomized patients are glucagon [G] deficient and if so, to what degree. Immunoreactive glucagon (IRG) concentrations in peripheral plasma of 9 pancreatectomized patients were not significantly different from those of 10 normal controls as measured by 2 antisera (30-K and RCS-5) both detecting the COOH-terminal portion of the molecule and one (RCS-5) postulated to be specific for pancreatic G. Plasma from 6 of 9 pancreatectomized patients were fractionated over Sephadex G-50 and IRG was measured with both antisera in the column eluates. Using 30-K, 80.8 .+-. 9% of the IRG eluted within the void volume. This material was rechromatographed on Sephadex G-200 and had an apparent MW of .apprx. 200,000. Only 18.3 .+-. 9% eluted in the IRG3500 region. IRG3500 was significantly reduced in pancreatectomized patients as compared to normal controls (49 .+-. 9 vs. 18 .+-. 9 pg/ml, P < 0.05). Using RCS-5, all IRG (corresponding to 20 .+-. 6 pg/ml of plasma) eluted in the IRG3500 region. The second goal of this study was to investigate the effects of chronic G deficiency on plasma amino acids. In the 9 pancreatectomized patients studied, postabsorptive plasma concentrations of Ser, Ala, Arg, Gly, Thr, citrulline, .alpha.-aminobutyrate and Tyr were significantly elevated compared to values obtained from 20 normal controls. Physiological G increments produced in 2 pancreatectomized patients by G infusion (6.25 and 8.0 .mu.g/h, respectively) resulted in normalization of the hyperaminoacidemia within 22 h. Apparently pancreatectomized patients are partially G deficient because of diminished basal as well as diminished stimulated G secretion; fasting concentrations of certain glucogenic amino acids are elevated in pancreatectomized patients probably as a result of reduced hepatic gluconeogenesis; and the RCS-5 antiserum is not pancreatic G specific.