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1 Department of Internal Medicine, Israelitic Hospital, University of Hamburg, Hamburg, Germany
2 Department of Medical Physiology, Panum Institute, University of Copenhagen, Copenhagen, Denmark
* To whom correspondence should be addressed. E-mail: layer{at}ik-h.de.
Lipid perfusion into the distal ileal lumen at supraphysiological loads inhibits pancreatic exocrine secretion and gastrointestinal motility in humans. Aim: To determine the effects of physiological postprandial intraileal lipid concentrations on endogenously stimulated pancreaticobiliary secretion, intestinal motility and release of regulatory mediators. Methods: 8 healthy volunteers were intubated with an oro-ileal multilumen tube for continuous duodenal perfusion of essential amino acids (450 µmol/min), ileal perfusion of graded doses of lipids (0, 50 and 100 mg/min, each dose for 90-120 min), aspiration of duodenal and ileal chyme and intestinal manometry. Venous blood samples were obtained for measurement of GLP-1 and PYY. Results: Ileal lipid perfusion dose-dependently decreased endogenously stimulated trypsin (262±59 vs. 154±42* vs. 92±20* U/min, *p<0.05) and bile acid output (18.6±1.9 vs. 8.4±2.8* vs. 3.0±1.0* µmol/min, p<0.05). Duodenal motor activity was not inhibited by either lipid dose. Trypsin and bile acid output correlated inversely with release of GLP-1 and PYY (IRI>0.84, p<0.05), whereas motility index did not. Conclusions: Physiological postprandial ileal lipid concentrations dose-dependently inhibit human digestive pancreatic protease and bile acid output but not intestinal motor activity. Thus, physiological postprandial ileal nutrient exposure may be of importance for termination of digestive secretory responses. Ileocolonic release of GLP-1 and PYY appears to participate in mediating these effects.
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