Effects of spiroglumide, a gastrin receptor antagonist, on acid secretion in humans

Background A gastrin receptor antagonist, CR2194 (spiroglumide), was used t o explore the physiological role of gastrin in regulating gastric acid secr etion in humans. Materials and methods The effect of CR2194 on inhibition of gastrin-stimula ted acid output was evaluated in a four-period crossover study. Each subjec t received intravenous doses of 1, 2.5 or 7.5 mg kg(-1) h(-1) CR2194 or sal ine (control) followed by graded increasing doses of gastrin (6.4-800 pmol kg(-1) h(-1)). Secondly, the effect of CR2194 on meal-stimulated intragastr ic acidity was evaluated by infusing either saline (control) or CR2194 (7.5 mg kg(-1) h(-1)) before and after food ingestion. Results Acid secretion was dose-dependently inhibited by CR2194. With CR219 4, acidity was significantly reduced in the pre-meal and post-prandial peri od (P < 0.01 and 0.002 respectively), and the integrated gastrin response w as augmented to 8.0 +/- 1.4 ng mL(-1) 240 min compared with 1.5 +/- 0.8 ng mL(-1) 240 min in the control experiment (P < 0.01). Finally, acid secretio n in response to sham feeding was significantly reduced: 15.9 +/- 0.9 mmol 90 min(-1) in the control experiment compared with 2.8 +/- 0.9 mmol 90 min( -1) during CR2194 infusion (P < 0.05). Conclusion Gastrin receptor blockade with CR2194 alters gastric acid secret ion in response to food ingestion or to sham feeding. The results support a physiological role for gastrin in regulating acid secretion in humans.