STUDIES ON DUODENAL CYCLIC AMP IN PANCREATIC DISEASE USING THE PANCREOZYMIN-SECRETIN TEST.

11例の健常例,18例の慢性膵炎例,6例の急性膵炎例および5例の膵癌例においてPS試験の際得られた十二指腸液中のcyclic AMPを測定した.cyclic AMPは健常群においてはsecretinによる膵bicarbonate分泌の細胞内mediatorとして働いていると考えられるが,膵疾患時にはcyclic AMP-bicarbonate分泌機構が円滑に働かないと考えられ,量的にもcyclic AMP outputは低下していた.すべての群においてcyclic AMP outputはbicarbonateおよびamylase outputの上昇と同様にpancreozyminおよびsecretin刺激後にピークに達した.cyclic AMP outputは健常群に比し,膵疾患群では有意に低下した.一方,pancreozyminによるamylase分泌にはcyclic AMPは関与していないと考えられた.十二指腸液中のcyclic AMPはPS試験のparameterとして応用できる可能性があると考えられた.しかしながら十二指腸液中のcyclic AMPの起源は膵のみでなく,膵,胆道系および十二指腸分泌の総合的な表現の可能性も考えられた.Cyclic AMP output in the duodenal contents of 11 normal subjects, 18 patients with chronic pancreatitis, 6 with acute pancreatitis and 5 with pancreatic carcinoma was measured after administration of a single dose of pancreozymin and secretin. Cyclic AMP seems to play a role as an intracellular mediator of pancreatic bicarbonate secretion of secretin in normal subjects, but the cyclic AMP-bicarbonate secretion system is possibly damaged and cyclic AMP output is decreased in pancreatic diseases. In all groups, the cyclic AMP output reached a peak after the concomitant increase of bicarbonate and amylase. A significantly decreased cyclic AMP output was observed in all pancreatic disease groups compared to the normal group. Amylase secretion due to administration of pancreozymin is not related to cyclic AMP. The cyclic AMP content of duodenal juice could be a parameter of the pancreozymin-secretin test. Nevertheless, cyclic AMP in duodenal juice should be considered not as only pancreatic but as pancreatic, biliary and duodenal in origin