[Behavior of exocrine pancreatic function during treatment with antibiotics and antineoplastic agents]

The thesis is composed of two parts, the first part is concerned with experiments in rats, the second part confirms the findings in human beings. After administration of oxytetracycline, chloramphenicol and cyclophosphamide, respectively, to rats an approximately dose-dependent decrease in the pancreatic secretion of proteins and enzyme activities was demonstrable in vivo under exogenous stimulation. The exocrine pancreatic function was studied in humans by performing a secretin-pancreocymin test before and after treatment with oxytetracycline or chloramphenicol and before and after massive-dose therapy with cyclophosphamide or combined cytotoxic treatment (as outlined by De Vita). The investigations further included an examination of the exocrine pancreatic function in subjects on maintenance therapy with cyclophosphamide or busulfan and a comparison with the exocrine pancreatic function in a group of controls. In the oxytetracycline-treated humans there was a depression of the amylase and lipase activities in the duodenal secretion. Administration of chloramphenicol produced a decrease in the amylase output only. In the patients on massive-dose or continued therapy with cyclophosphamide the pancreatic function remained essentially unchanged. In contrast, cytotoxic combination treatment resulted in decreased activities of amylase and lipase. After maintenance treatment with busulfan a reduction of the trypsin and amylase activities was detectable. The volume and electrolyte outputs were found to remain essentially unchanged in all investigations. An impairment in enzyme synthesis is suggested as the major cause of the observed changes of pancreatic secretion after antibiotic and cytotoxic treatment.