Oral pancreatic
enzyme replacement therapy generally benefits patients with severe pancreatic deficiency. However, the fate of oral pancreatic supplements in the digestive lumen and their possible effects on circulating gut
hormones are only partially known. The purpose of this article is to validate an experimental model that produces total
pancreatic insufficiency in pigs, and to study the fate of orally administered
Eurobiol, a whole pancreas lyophilized preparation, and its effects on circulating plasma levels of five digestive
hormones.
Pancreatic insufficiency was created by pancreatic duct
ligation, and the duodenal, jejunal and ileal contents were sampled through cannulas before a normal meal and 0.5-24 h later. Blood samples were taken at the same times, and plasma
neurotensin,
pancreatic polypeptide,
secretin,
cholecystokinin (CCK), and
gastrin were measured. In pigs with
pancreatic insufficiency,
Eurobiol, given during the meal, induced a significant increase in all
enzyme activities in the duodenum and the jejunum, and in the levels of
amylase,
trypsin, and
chymotrypsin in the ileum, relative to placebo. In the duodenum, the peak concentrations of
enzyme activities were 19, 11, 17, and 29% (p less than 0.001) of the postprandial peak activities measured in control pigs with an intact pancreas for
lipase,
amylase,
trypsin, and
chymotrypsin, respectively. In the jejunum, the same activities were, respectively, 30, 11, 25, and 36% (p less than 0.01-0.001) of normal peaks. In pigs with
pancreatic insufficiency, basal and integrated meal-stimulated
neurotensin levels were increased; basal, peak, and integrated meal-stimulated
pancreatic polypeptide and
secretin levels were increased, whereas
gastrin and CCK were not different from controls.(ABSTRACT TRUNCATED AT 250 WORDS)