Consult the medical resource doctors trust

UpToDate is one of the most respected medical information resources in the world, used by over 360,000 doctors and thousands of patients to find answers to medical questions.

  • Content written by a faculty of over 4,000 physicians from leading medical institutions
  • Unbiased: free of advertising or pharmaceutical funding
  • Evidence-based treatment recommendations
  • Continuously updated to incorporate new medical findings

Physiology of gastrin

INTRODUCTION

Gastrin is the major hormonal regulator of gastric acid secretion [1]. Its discovery at the turn of the century was based upon its profound effect on meal-stimulated acid secretion, making it one of the first hormones to be described [1]. The study of gastrin accelerated with the isolation and characterization of the peptide in 1964 after which it was found to promote growth of the gastric antrum and have a proliferative effect, which has implicated it as having a possible role in cancer [2,3]. The cloning and characterization of the gastrin receptor in 1992 has provided a valuable tool in the study of gastrointestinal hormones [4]

MOLECULAR FORMS

Human gastrin is the product of a single gene located on chromosome 17. The active hormone is generated from a precursor peptide "pre-pro-gastrin" (graph 1). Human preprogastrin contains 101 amino acids (AA) including a signal peptide (21 AA), spacer sequence (37 AA), gastrin component (34 AA) and a 9 AA extension segment at the carboxyl terminus. The enzymatic processing of preprogastrin produces all of the known physiologically active forms of gastrin.

Preprogastrin is processed into progastrin and gastrin peptide fragments of various sizes by sequential enzymatic cleavage (graph 1). Like other hormones, gastrin is synthesized on rough endoplasmic reticulum, processed in the Golgi apparatus and packaged in secretory granules, where final modifications occur [5]. In endocrine cells, the glycine residue at the carboxyl terminus is cleaved and the terminus is amidated to form the mature gastrin peptide.

Two major forms of gastrin are secreted (G-34 and G-17), although a larger G-71 and smaller forms exist (table 1). The common feature of all gastrins is an amidated tetrapeptide (Try-Met-Asp-Phe-NH2) at the carboxyl terminus, which imparts full biological activity. Modification by sulfation at tyrosine residues produces alternative gastrin forms. The circulating half-life of gastrin is affected by the size of the various molecular forms. The full physiologic response is determined by the presence of the biologically active moiety and the time available for receptor interaction. (See "Synthesis, secretion, and regulation of gastrointestinal peptides".)

Gastrin can be ectopically expressed in non-endocrine cells, such as tumors. However, because these cells lack secretory vesicles, prohormone convertases and amidating enzymes, the main forms of gastrin secreted are progastrins including glycine-extended gastrin. These forms of gastrin may have growth promoting effects on certain tumors.

To continue reading this article you need to subscribe.

Read the rest of this article and others like it

The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use (click here) ©2009 UpToDate, Inc.
References Top
  1. Edkins, JS. On the chemical mechanism of gastric secretion. Proc R Soc Lond B Biol Sci 1905; 76:376.
  2. Gregory, RA, Tracy, HJ. The constitution and properties of two gastrins extracted from hog antral mucosa. Gut 1964; 46:103.
  3. Joshi, SN, Gardner, JD. Gastrin and colon cancer: A unifying hypothesis. Dig Dis 1996; 14:334.
  4. Kopin, AS, Lee, YM, McBride, EW, et al. Expression cloning and characterization of the canine parietal cell gastrin receptor. Proc Natl Acad Sci U S A 1992; 89:3605.
  5. Rehfeld, JF. Processing of precursors of gastroenteropancreatic hormones: Diagnostic significance. J Mol Med 1998; 76:338.
  6. Rehfeld, JF. The new biology of gastrointestinal hormones. Physiol Rev 1998; 78:1087.
  7. Hellmich, MR, Rui, XL, Hellmich, HL, et al. Human colorectal cancers express a constitutively active cholecystokinin-B/gastrin receptor that stimulates cell growth. J Biol Chem 2000; 275:32122.
  8. Harris, JC, Clarke, PA, Awan, A, et al. An antiapoptotic role for gastrin and the gastrin/CCK-2 receptor in Barrett's esophagus. Cancer Res 2004; 64:1915.
  9. Smith, JP, Verderame, MF, McLaughlin, P, et al. Characterization of the CCK-C (cancer) receptor in human pancreatic cancer. Int J Mol Med 2002; 10:689.
  10. Hersey, SJ, SAchs, G. Gastric acid secretion. Physiol Rev 1995; 75:155.
  11. Sachs, G, Prinz, P. Gastric enterochromaffin-like cells and the regulation of acid secretion. News in Physiological Sci 1996; 11:57.
  12. Wang, TC, Dockray, GJ. Lessons from genetically engineered animal models. I. Physiological studies with gastrin in transgenic mice. Am J Physiol 1999; 277:G6.
  13. Koh, TJ, Goldenring, JR, Ito, S, et al. Gastrin deficiency results in altered gastric differentiation and decreased colonic proliferation in mice. Gastroenterology 1997; 113:1015.
  14. Chen, D, Zhao, CM, Dockray, GJ, et al. Glycine-extended gastrin synergizes with gastrin 17 to stimulate acid secretion in gastrin-deficient mice. Gastroenterology 2000; 119:756.
  15. Nagata, A, Ito, M, Iwata, N, et al. G protein-coupled cholecystokinin-B/gastrin receptors are responsible for physiological cell growth of the stomach mucosa in vivo. Proc Natl Acad Sci U S A 1996; 93:11825.
  16. Langhans, N, Rindi, G, Chiu, M, et al. Abnormal gastric histology and decreased acid production in cholecystokinin-receptor-deficient mice. Gastroenterology 1997; 112:280.
  17. Friis-Hansen, L. Lessons from the gastrin knockout mice. Regul Pept 2007; 139:5.
  18. Calam, J, Gibbons, A, Healey, ZV, et al. How does Helicobacter pylori cause mucosal damage? Its effect on acid and gastrin physiology. Gastroenterology 1997; 113:S43.
  19. Okosdinossian, ET, Munshid, HA, Wasfi, AI, et al. Fasting plasma-gastrin in vitiligo [letter]. Lancet 1978; 1:997.
  20. Netter, P, Faure, G, Brassine, A, et al. Hypergastrinemia in rheumatoid arthritis is related to Sjogren's syndrome [letter]. J Rheumatol 1985; 12:651.
  21. Korman, MG, Laver, MC, Hansky, J. Hypergastrinaemia in chronic renal failure. Br Med J 1972; 1:209.
  22. Clerc, P, Dufresne, M, Saillan, C, et al. Differential expression of the CCK-A and CCK-B/gastrin receptor genes in human cancers of the esophagus, stomach and colon. Int J Cancer 1997; 72:931.
  23. de Weerth, A, von Schrenck, T, Lohr, M, et al. Human pancreatic cancer cell lines express the CCKB receptor. Hepatogastroenterology 1999; 46:472.
  24. Jensen, RT. Involvement of cholecystokinin/gastrin-related peptides and their receptors in clinical gastrointestinal disorders. Pharmacol Toxicol 2002; 91:333.
  25. Havu, N. Enterochromaffin-like cell carcinoids of gastric mucosa in rats after life-long inhibition of gastric secretion. Digestion 1986; 35 Suppl 1:42.
  26. Bordi, C, D'Adda, T, Azzoni, C, et al. Hypergastrinemia and gastric enterochromaffin-like cells. Am J Surg Pathol 1995; 19 Suppl 1:S8.
  27. Gibril, F, Schumann, M, Pace, A, Jensen, RT. Multiple endocrine neoplasia type 1 and zollinger-ellison syndrome: a prospective study of 107 cases and comparison with 1009 cases from the literature. Medicine (Baltimore) 2004; 83:43.
  28. Cadiot, G, Laurent-Puig, P, Thuille, B, et al. Is the multiple endocrine neoplasia type 1 gene a suppressor for fundic argyrophil tumors in the Zollinger-Ellison syndrome?. Gastroenterology 1993; 105:579.
  29. Nakata, H, Wang, SL, Chung, DC, et al. Oncogenic ras induces gastrin gene expression in colon cancer. Gastroenterology 1998; 115:1144.
  30. Renga, M, Brandi, G, Paganelli, GM, et al. Rectal cell proliferation and colon cancer risk in patients with hypergastrinaemia. Gut 1997; 41:330.
  31. Thorburn, CM, Friedman, GD, Dickinson, CJ, et al. Gastrin and colorectal cancer: A prospective study. Gastroenterology 1998; 115:275.
  32. Grabowska, AM, Watson, SA. Role of gastrin peptides in carcinogenesis. Cancer Lett 2007; 257:1.
  33. Bold, RJ, Ishizuka, J, Townsend, CM Jr. Progress toward hormonal therapy of gastrointestinal cancer. Ann Surg 1996; 223:4.
  34. Stepan, VM, Sawada, M, Todisco, A, Dickinson, CJ. Glycine-extended gastrin exerts growth-promoting effects on human colon cancer cells. Mol Med 1999; 5:147.
  35. Litvak, DA, Hellmich, MR, Iwase, K, et al. JMV1155: A novel inhibitor of glycine-extended progastrin-mediated growth of a human colon cancer in vivo. Anticancer Res 1999; 19:45.
  36. Kelly, A, Hollande, F, Shulkes, A, Baldwin, GS. Expression of progastrin-derived peptides and gastrin receptors in a panel of gastrointestinal carcinoma cell lines. J Gastroenterol Hepatol 1998; 13:208.
  37. Van Solinge, WW, Nielsen, FC, Friis-Hansen, L, et al. Expression but incomplete maturation of progastrin in colorectal carcinomas. Gastroenterology 1993; 104:1099.
  38. Ciccotosto, GD, McLeish, A, Hardy, KJ, Shulkes, A. Expression, processing, and secretion of gastrin in patients with colorectal carcinoma. Gastroenterology 1995; 109:1142.
  39. Bombski, G, Gasiorowska, A, Orszulak-Michalak, D, et al. Elevated plasma gastrin, CEA, and CA 19-9 levels decrease after colorectal cancer resection. Int J Colorectal Dis 2003; 18:148.
  40. Smith, AM, Watson, SA. Gastrin and gastrin receptor activation: an early event in the adenoma-carcinoma sequence. Gut 2000; 47:820.
  41. Ramamoorthy, S, Stepan, V, Todisco, A. Intracellular mechanisms mediating the anti-apoptotic action of gastrin. Biochem Biophys Res Commun 2004; 323:44.
  42. Clarke, PA, Dickson, JH, Harris, JC, et al. Gastrin enhances the angiogenic potential of endothelial cells via modulation of heparin-binding epidermal-like growth factor. Cancer Res 2006; 66:3504.
  43. Orlando, LA, Lenard, L, Orlando, RC. Chronic hypergastrinemia: causes and consequences. Dig Dis Sci 2007; 52:2482.
  44. Smith, JP, Shih, A, Wu, Y, et al. Gastrin regulates growth of human pancreatic cancer in a tonic and autocrine fashion. Am J Physiol 1996; 270:R1078.
  45. Smith, JP, Verderame, MF, Zagon, IS. Antisense oligonucleotides to gastrin inhibit growth of human pancreatic cancer. Cancer Lett 1999; 135:107.
  46. El-Zimaity, HM, Jackson, FW, Graham, DY. Fundic gland polyps developing during omeprazole therapy. Am J Gastroenterol 1997; 92:1858.
  47. Chowers, MY, Keller, N, Tal, R, et al. Human gastrin: A helicobacter pylori-specific growth factor. Gastroenterology 1999; 117:1113.
  48. Payne, NA, Gerber, JG. Differential effects of somatostatin and prostaglandins on gastric histamine release to pentagastrin. J Pharmacol Exp Ther 1992; 263:520.
  49. Brunt, LM, Mazoujian, G, O'Dorisio, TM, Wells, SA Jr. Stimulation of vasoactive intestinal peptide and neurotensin secretion by pentagastrin in a patient with VIPoma syndrome. Surgery 1994; 115:362.
white circle LOG IN
white circle DEMO