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Tumour necrosis factor alpha antibody affects gastrin release in Crohn disease
W P M Hopman1, D J de Jong, A H J Naber
1Dept. of Gastroenterology and Hepatology, University Medical Center Nijmegen, Nijmegen, The Netherlands. W.Hopman@mdl.umcn.nl
Background:
Gastrin plays an important role in the regulation of gastric acid secretion in humans. Tumour necrosis factor alpha (TNF-alpha) stimulates gastrin release from antral G cells in vitro. The aim was to determine whether gastrin release decreases in patients with Crohn disease treated with monoclonal antibody to TNF-alpha.
Methods:
Twenty-five consecutive patients with Crohn disease (10 M, 15 F; 18 with fistulas) were treated with a single intravenous infusion of the monoclonal antibody to TNF-alpha, infliximab, at a dose of 5 mg/kg. Basal and bombesin stimulated gastrin was measured after an overnight fast immediately before and 2 weeks after infliximab. Helicobacter pylori status was determined by serology.
Results:
Twenty-two patients were H. pylori-negative. Basal plasma gastrin was 21 (16-26) pmol/L before and 19 (15-25) pmol/L after infliximab (NS). Bombesin stimulated gastrin decreased from 49 (40-62) pmol/L before to 36 (33-59) pmol/L (P < 0.005) 2 weeks after infliximab.
Conclusion:
Gastrin release in response to bombesin decreases in patients with Crohn disease treated with infliximab.