, Volume 35, Supplement 3, pp 10–16 | Cite as

The Significance of Gastrin in the Pathogenesis and Therapy of Peptic Ulcer Disease

  • C. B. H. W. Lamers
Section 1: Clinical Considerations


Gastrin, a polypeptide hormone secreted by G (gastrin)-cells in the antroduodenal mucosa, is not only a potent stimulant of gastric acid secretion but also exerts trophic actions on the parietal, chief and enterochromaffin-like cells in the oxyntic mucosa. Gastrin plays a crucial role in the pathogenesis of hypergastrinaemic peptic ulcer disease, i.e. in the Zollinger-Ellison syndrome, antral G-cell hyperfunction and retained excluded antrum after subtotal gastrectomy. In patients with normogastrinaemic duodenal ulcer disease the feedback mechanism between gastric acid and gastrin secretion is impaired, while in gastric ulcer patients gastrin secretion is appropriately regulated by gastric acid.

Antisecretory drugs may exert varying effects on gastrin secretion. Potent antisecretory drugs, such as omeprazole, increase serum and antral gastrin concentrations, whereas histamine H2-receptor antagonists, such as cimetidine, ranitidine, famotidine and roxatidine, have little influence on gastrin. Interestingly, antisecretory doses of prostaglandin E2-analogues, such as enprostil and arbaprostil [15(R)-15-methylprostaglandin E2], inhibit gastrin secretion, while gastrin is not influenced by prostaglandin E1-analogues, e.g. misoprostol. Somatostatin and the somatostatin-analogue SMS 201-995 reduce serum gastrin levels and gastric acid secretion.


Peptic Ulcer Disease Gastric Acid Secretion Serum Gastrin Roxatidine Serum Gastrin Level 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Arnold R, Koop H, Schwarting H, Tuch K, Willemer B. Effect of acid inhibition on gastric endocrine cells. Scandinavian Journal of Gastroenterology 21 (Suppl. 125): 14–19, 1986CrossRefGoogle Scholar
  2. Buchanan N, Laferla G, Hearns J, Buchanan KD, Crean GP, et al. Effect of a single oral dose of enprostil on gastric secretion and gastrin release. American Journal of Medicine 81 (Suppl. 2A): 40–43, 1986PubMedCrossRefGoogle Scholar
  3. Byrnes DJ, Lam SK, Sircus W. The relationship between functioning parietal cell and gastrin cell masses in two groups of duodenal ulcer patients. Clinical Sciences and Molecular Medicine 50: 375–383, 1976Google Scholar
  4. Creutzfeldt W, Arnold R. Somatostatin and the stomach: exocrine and endocrine aspects. Metabolism 27 (Suppl. 1): 1309–1315, 1978PubMedCrossRefGoogle Scholar
  5. Crobach LFSJ, Jansen JBMJ, Lamers CBHW. Effect of enprostil on basal and postprandial serum gastrin levels in patients with antral G-cell hyperfunction, Zollinger-Ellison syndrome and normal subjects. Gut 27: A1282, 1986Google Scholar
  6. Festen HPM, Thijs JC, Lamers CBHW, Jansen JBMJ, Pals G, et al. The effect of oral omeprazole on serum gastrin and serum pepsinogen levels. Gastroenterology 87: 1030–1034, 1984PubMedGoogle Scholar
  7. Fritsch WP, Hausamen TU, Rick W. Gastric and extragastric gastrin release in normal subjects, in duodenal ulcer patients, and in patients with partial gastrectomy (Billroth I). Gastroenterology 71: 552–557, 1976PubMedGoogle Scholar
  8. Inoue M. Experiences with roxatidine in Japan. Drugs 35 (Suppl. 3): 114–119, 1988PubMedCrossRefGoogle Scholar
  9. Isenberg JI, Grossman MI, Maxwell V, Walsh JH. Increased sensitivity to stimulation of acid secretion by pentagastrin in duodenal ulcer. Journal of Clinical Investigation 55: 330–337, 1975PubMedCrossRefGoogle Scholar
  10. Kleibeuker JH, Lamers CBHW. Effect of selective and non-selective cholinergic blockade on bombesin- and peptone-stimulated gastrin release. European Journal of Clinical Pharmacology 33: 319–321, 1987PubMedCrossRefGoogle Scholar
  11. Konturek SJ, Swierczek JS, Kwiecient N, Obtulowicz W, Sito E, et al. Effect of orally administered 15(R)-15-methylprostaglandin E2and/or an anticholinergic drug on meal-induced gastric acid secretion and serum gastrin level in patients with duodenal ulcers. Scandinavian Journal of Gastroenterology 14: 813–819, 1979PubMedCrossRefGoogle Scholar
  12. Koop H, Schwarting H, Knorr-Marin A, Willhardt C, Möser T, et al. Influence of chronic omeprazole treatment on gastric endocrine function. Klinische Wochenschrift 65: 169–173, 1987PubMedCrossRefGoogle Scholar
  13. Lam SK. Pathogenesis and pathophysiology of duodenal ulcer. Clinics in Gastroenterology 13: 447–472, 1984PubMedGoogle Scholar
  14. Lam SK, Isenberg JI, Grossman MI, Lane WH, Walsh JH, Gastric acid secretion is abnormally sensitive to endogenous gastrin released after peptone test meals in duodenal ulcer patients. Journal of Clinical Investigation 65: 555–562, 1980PubMedCrossRefGoogle Scholar
  15. Lamers CBHW. Clinical usefulness of the secretin provocation test. Journal of Clinical Gastroenterology 3: 255–259, 1981PubMedCrossRefGoogle Scholar
  16. Lamers CBHW. Clinical and pathophysiological aspects of somatostatin and the gastrointestinal tract. Acta Endocrinologica 116 (Suppl. 286): 19–25, 1987Google Scholar
  17. Lamers CBHW, Lind T, Moberg S, Jansen JBMJ, Olbe L. Omeprazole in Zollinger-Ellison syndrome. New England Journal of Medicine 310: 758–762, 1984CrossRefGoogle Scholar
  18. McGuigan JE, Chang J, Dajani EZ. Effect of misoprostol, an an-tiulcer prostaglandin, on serum gastrin in patients with duodenal ulcer. Digestive Diseases and Sciences 31: 120S–125S, 1986PubMedCrossRefGoogle Scholar
  19. Mignon M, Vatier J, Bauer P, Bonfils S. Effect of pirenzepine on meal-stimulated acid secretion and gastrin release in normal man. Scandinavian Journal of Gastroenterology 18 (Suppl. 72): 145–151, 1982Google Scholar
  20. Mohammed R, Holden RJ, Hearns JB, McKibben BM, Buchanan KD, et al. Effects of eight weeks’ continuous treatment with oral ranitidine and cimetidine on gastric acid secretion, pepsin secretion, and fasting serum gastrin. Gut 24: 61–66, 1983PubMedCrossRefGoogle Scholar
  21. Nelis GF, Lamers CBHW, Pals G. Influence of RP 40749 on basal and meal-stimulated serum gastrin, serum pepsinogen I and gastrin content of the antral mucosa. Digestive Diseases and Sciences 30: 617–623, 1985PubMedCrossRefGoogle Scholar
  22. Peterson W, Feldman M, Taylor I, Bremer M. The effect of 15(R)-15-methylprostaglandin E2 on meal-stimulated gastric acid secretion, serum gastrin, and pancreatic polypeptide in duodenal ulcer patients. Digestive Diseases and Sciences 24: 381–384, 1979PubMedCrossRefGoogle Scholar
  23. Polak JH, Bloom SR, Bishop HF, McGrossan MV. D cell pathology in duodenal ulcers and achlorhydria. Metabolism 27 (Suppl. 1): 1239–1242, 1978PubMedCrossRefGoogle Scholar
  24. Saffouri B, Weir CG, Bitar KN, Makhlouf G. Gastrin and somatostatin secretion by perfused rat stomach: functional linkage of antral peptides. American Journal of Physiology 238: G 495–501, 1980Google Scholar
  25. Schulte K, Singer MV, Eysselein V, Demol P, Goebell H. Effect of rioprostil, a synthetic prostaglandin E1on meal-stimulated gastric acid secretion and plasma gastrin levels in humans. Digestion 36: 162–167, 1987PubMedCrossRefGoogle Scholar
  26. Sumii K, Fukushima T, Hirata T, Matsumoto Y, Sanuki E, et al. Antral gastrin and somatostatin concentrations in peptic ulcer patients. Peptides (Suppl. 2): 281–283, 1981Google Scholar
  27. Sundler F, Carlson E, Hakanson R, Larsson H, Mattson H. Inhibition of gastric acid secretion by omeprazole and ranitidine. Scandinavian Journal of Gastroenterology 21 (Suppl. 118): 39–45, 1986CrossRefGoogle Scholar
  28. Taylor IL. Gastrointestinal hormones in the pathogenesis of peptic ulcer disease. Clinics in Gastroenterology 13: 355–382, 1984PubMedGoogle Scholar
  29. Thomas FJ, Koss MA, Hogan DL, Isenberg JI. Enprostil, a synthetic prostaglandin E2analogue, inhibits meal-stimulated gastric acid secretion and gastrin release in patients with duodenal ulcer. American Journal of Medicine 81 (Suppl. 2A): 44–49, 1986PubMedCrossRefGoogle Scholar
  30. Walsh JH, Lam SK. Physiology and pathophysiology of gastrin. Clinics in Gastroenterology 9: 567–591, 1980PubMedGoogle Scholar
  31. Walsh JH, Richardson T, Fordtran J. pH dependence of acid secretion and gastrin release in normal and ulcer subjects. Journal of Clinical Investigation 55: 462–468, 1975PubMedCrossRefGoogle Scholar
  32. Williams G, Fuessl H, Kraenzlin M, Bloom SR. Postprandial effects of SMS 201-995 on gut hormones and glucose tolerance. Scandinavian Journal of Gastroenterology 21 (Suppl. 119): 73–83, 1986CrossRefGoogle Scholar

Copyright information

© ADIS Press Limited 1988

Authors and Affiliations

  • C. B. H. W. Lamers
    • 1
  1. 1.Department of Gastroenterology-HepatologyLeiden University HospitalLeidenThe Netherlands

Personalised recommendations