Functional, Diagnostic and Therapeutic Aspects of Gastrointestinal Hormones

Abstract

Endocrinology experienced an unexpected impetus in recent years, when it became possible to determine hormones radioimmunologically in the circulating blood. The fact that the digestive tract is by far the largest endocrine organ in man has tended to be forgotten, though this should occasion no surprise, seeing that this organ is so closely in contact with the environment, which itself is determined by food intake and its metabolism. The number of gastrointestinal hormones that have been discovered in recent years, and to some extent have already been synthesized, has nearly doubled, and in addition to the diagnostic possibilities that have arisen, the therapeutic aspects based on their physiological and pharmacological properties and the reciprocal integration of the individual hormones are evident. In the case of most gastrointestinal hormones (gastrin, secretin, cholecystokinin, motilin, VIP) synthetically manufactured analogues are now produced, and these have an effect which is either as marked as, or even more marked than, those of the naturally occurring hormones, which can only be produced in the pure form from organ extracts at a high cost. The majority of the diagnostic and therapeutic possibilities discussed in this paper have not yet been achieved clinically, partly because development in recent years has proceeded extremely rapidly, and much knowledge has not yet become generally available, and partly because pharmaceutical industry has not yet reached the desirable stage of industrial manufacture. But there remains no doubt that new types of therapy with gastrointestinal hormones, related to the causes of the various conditions, will be introduced.