It is controversial whether
acute pancreatitis has longterm effects on pancreatic function. Pancreatic
enzyme synthesis, turnover, and secretion were measured in 10 patients in clinical remission who had had one or more (one to six) attacks of acute
alcoholic pancreatitis. The studies were done between two and 29 months after the most recent attack. A control group included five patients with no evidence of
pancreatic disease. A four hour primed/continuous
intravenous infusion of [14C]
L-leucine tracer was given with
secretin (2 U/kg/h) and
cholecystokinin (0.5 U/kg/h) and secreted duodenal juice aspirated.
Amylase and
trypsin were extracted from duodenal juice by affinity chromatography, permitting measurement of the rate of
isotope incorporation into total
protein,
amylase, and
trypsin. The results showed non-parallel changes in
enzyme synthesis and turnover with decreases in total
enzyme protein and
amylase synthesis and turnover but preservation of
trypsin synthesis and turnover. The low turnover rates may be ascribed to continuing pancreatic cell malfunction after recovery from acute
alcoholic pancreatitis and suggest that the decreased
amylase secretion rates are partly a consequence of impaired
amylase synthesis and not simply because of loss of pancreatic tissue.