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March 1974

Gastric Hypersecretion and Pancreatic Exocrine Deficiency

Author Affiliations

Bristol, England

Arch Surg. 1974;108(3):381. doi:10.1001/archsurg.1974.01350270111023

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To the Editor.—I have been following with interest the correspondence in the Archives between Dr. Silen (106:239, 1973) and Dr. Basso et al (106:364, 1973), following their paper on the mechanism of gastric hypersecretion in pancreatic exocrine deficiency (105:611-614, 1972). Recent studies in our laboratory suggest another possible explanation for their findings. Using a radioimmunoassay for cholecystokinin-pancreozymin (CCK-PZ),1 we have shown that pancreatic exocrine deficiency in man is associated with very high fasting levels of CCK-PZ in the serum,2 perhaps as a result of failure of the normal feedback inhibition of CCK-PZ secretion by a factor in pancreatic juice. Cholecystokinin-pancreozymin is structurally identical with gastrin in the C-terminal pentapeptide amide sequence, and therefore shows cross-reaction in gastrin immunoassay systems that employ antibodies directed toward this portion of the gastrin molecule. Basso and colleagues give no details of the antibody used in their gastrin assay, but if it

Harvey RF, et al: A radioimmunoassay for cholecystokinin-pancreozymin. Gut, to be published.
Harvey RF, et al:  A radioimmunoassay for cholecystokinin-pancreozymin . Lancet 2:826-828, 1973.Article
McGuigan JE:  Studies of the immunochemical specificity of some antibodies to human gastrin . Gastroenterology 56:429-438, 1969.
McGuigan JE:  Immunochemical studies with synthetic human gastrin . Gastroenterology 54:1005-1011, 1968.
Way LW:  Effect of cholecystokinin and caerulein on gastric secretion in cats . Gastroenterology 60:560-565, 1971.
Grossman MI:  Gastrin, cholecystokinin and secretin act as one receptor . Lancet 1:1088-1089, 1970.Article