Serum Levels of Human Pancreatic Polypeptide in Renal Disease
Scand J Gastroenterol Downloaded from informahealthcare.com by Flinders University of South Australia on 01/08/15 For personal use only.
R. HALLGREN, G. LUNDQVIST & R. E. CHANCE Depts. of Medicine and Clinical Chemistry, University Hospital, Uppsala, Sweden. and The Lilly Research Laboratories, Indianapolis, USA
Hallgren, R., Lundqvist, G. & Chance, R. E. Serum levels of human pancreatic polypeptide in renal disease. Scand. J. Gastroent. 1977, 12, 923-927 The newly recognized pancreatic polypeptide (PP) has been demonstrated in the circulation of healthy subjects, although its physiological role is not definitely established. In order to investigate the renal role in the elimination of PP from the circulation, PP was determined in patients with varying degrees of renal damage, in patients on chronic haemodi'alysis, and in patients who have undergone renal transplantation. A close correlation was found between glomerular filtration rate and serum PP. In the uraemic group, PP levels were highly elevated as compared to normal individuals. After renal transplantation, PP values declined in step with the improvement in glomerular filtration rate. The increased serum PP levels in renal failure raise the possibility of PP being involved in the development of uraemic gastrointestinal symptoms. Key-words: Pancreatic polypeptide; renal disease; renal failure; uraemia Gudmar Lundqvist. M.D., Dept. ofCIinica1 Chemistry, University Hospital. S-750 14 Uppsala, Sweden
The recently recognized Pancreatic Polypeptide (PP) has been demonstrated in the circulation of healthy subjects by radioimmunoassay (2, 10, 11). The physiological role of PP has not been defined, but good evidence exists for its functioning as a hormone. The polypeptide has been localized to the cytoplasmic granules of a population of pancreatic cells with properties as endocrine cells by an immunohistochemical technique ( 5 , 6). Raised serum PP levels have been demonstrated after ingestion of food ( 1 l), and in many patients having endocrine pancreatic tumours of different types (10). A specific connection between WDHA syndrome and an abnormal production of PP by the tumour has also been demonstrated (7). The sites of degradation and/or excretion of PP are unknown. In this paper we have investigated the possible role of the kidneys in the elimination of P P from the circulation. Immunoreactive PP has been assayed in patients with varying degrees of renal damage, in patients on chronic haemodialysis, and in patients who have undergone renal transplantation.
MATERIALS AND METHODS Fasting serum was obtained from 85 patients with various types of renal disorders. The most common diagnoses were glomerulonephritis, obstructive uropathy, and renal allograft. The mean age was 44 (range 16-7 1) years. Nineteen of the patients were on chronic maintenance haemodialysis. An additional 6 patients who had undergone renal transplantation were also studied during the 8- 10 weeks after operation. Serum and urine creatinine were determined by an autoanalyser technique (Technicon N 1 1 b). The normal r k g e of serum creatinine is 64- 106 pmol/l. Endogenous creatinine clearance was calculated for a 24-hour period. 51Cr-EDTA clearance was performed and calculated according t o the single injection technique described by Briichner-Mortensen (1). The serum level of /?,-microglobulin was determined by the use of a radioimmunoassay kit, Phadebas /?,-mikro test (Pharmacia AB, Sweden). The normal range of j,-microglobulin is 1.1-2.4mg/l. The serum level of P P was determined by a previously described radioimmunoassay (7), modified
Scand J Gastroenterol Downloaded from informahealthcare.com by Flinders University of South Australia on 01/08/15 For personal use only.
924
R . Hallgren. G.Lundqvist & R. E. Chance
I00
500
loo0
m
#
loo00 20000 f%NCREATK POLYPEPTIDE ngll
Fig. 1. Correlation between the serum level of PP and the serum level of j2microglobulin in 85 patients with renal disease. The solid line is the regression line (log y=0.459 log x -0.456). The correlation coefficient in 0.74 (p
Scand J Gastroenterol Downloaded from informahealthcare.com by Flinders University of South Australia on 01/08/15 For personal use only.
R. HALLGREN, G. LUNDQVIST & R. E. CHANCE Depts. of Medicine and Clinical Chemistry, University Hospital, Uppsala, Sweden. and The Lilly Research Laboratories, Indianapolis, USA
Hallgren, R., Lundqvist, G. & Chance, R. E. Serum levels of human pancreatic polypeptide in renal disease. Scand. J. Gastroent. 1977, 12, 923-927 The newly recognized pancreatic polypeptide (PP) has been demonstrated in the circulation of healthy subjects, although its physiological role is not definitely established. In order to investigate the renal role in the elimination of PP from the circulation, PP was determined in patients with varying degrees of renal damage, in patients on chronic haemodi'alysis, and in patients who have undergone renal transplantation. A close correlation was found between glomerular filtration rate and serum PP. In the uraemic group, PP levels were highly elevated as compared to normal individuals. After renal transplantation, PP values declined in step with the improvement in glomerular filtration rate. The increased serum PP levels in renal failure raise the possibility of PP being involved in the development of uraemic gastrointestinal symptoms. Key-words: Pancreatic polypeptide; renal disease; renal failure; uraemia Gudmar Lundqvist. M.D., Dept. ofCIinica1 Chemistry, University Hospital. S-750 14 Uppsala, Sweden
The recently recognized Pancreatic Polypeptide (PP) has been demonstrated in the circulation of healthy subjects by radioimmunoassay (2, 10, 11). The physiological role of PP has not been defined, but good evidence exists for its functioning as a hormone. The polypeptide has been localized to the cytoplasmic granules of a population of pancreatic cells with properties as endocrine cells by an immunohistochemical technique ( 5 , 6). Raised serum PP levels have been demonstrated after ingestion of food ( 1 l), and in many patients having endocrine pancreatic tumours of different types (10). A specific connection between WDHA syndrome and an abnormal production of PP by the tumour has also been demonstrated (7). The sites of degradation and/or excretion of PP are unknown. In this paper we have investigated the possible role of the kidneys in the elimination of P P from the circulation. Immunoreactive PP has been assayed in patients with varying degrees of renal damage, in patients on chronic haemodialysis, and in patients who have undergone renal transplantation.
MATERIALS AND METHODS Fasting serum was obtained from 85 patients with various types of renal disorders. The most common diagnoses were glomerulonephritis, obstructive uropathy, and renal allograft. The mean age was 44 (range 16-7 1) years. Nineteen of the patients were on chronic maintenance haemodialysis. An additional 6 patients who had undergone renal transplantation were also studied during the 8- 10 weeks after operation. Serum and urine creatinine were determined by an autoanalyser technique (Technicon N 1 1 b). The normal r k g e of serum creatinine is 64- 106 pmol/l. Endogenous creatinine clearance was calculated for a 24-hour period. 51Cr-EDTA clearance was performed and calculated according t o the single injection technique described by Briichner-Mortensen (1). The serum level of /?,-microglobulin was determined by the use of a radioimmunoassay kit, Phadebas /?,-mikro test (Pharmacia AB, Sweden). The normal range of j,-microglobulin is 1.1-2.4mg/l. The serum level of P P was determined by a previously described radioimmunoassay (7), modified
Scand J Gastroenterol Downloaded from informahealthcare.com by Flinders University of South Australia on 01/08/15 For personal use only.
924
R . Hallgren. G.Lundqvist & R. E. Chance
I00
500
loo0
m
#
loo00 20000 f%NCREATK POLYPEPTIDE ngll
Fig. 1. Correlation between the serum level of PP and the serum level of j2microglobulin in 85 patients with renal disease. The solid line is the regression line (log y=0.459 log x -0.456). The correlation coefficient in 0.74 (p
