Pentagastrin increases pepsin secretion without increasing its fractional synthetic rate

We studied the effects of increasing doses of pentagastrin on gastric secretion of pepsin and on incorporation of L-[1-¹³C]leucine into gastric aspirate protein as an index of pepsin synthesis. Pentagastrin (0.25-4.0 μg · kg^-1 · h^-1) significantly increased pepsin output from basal 76 mg/h to ≤ 181 mg/h but did not significantly alter incorporation of L-[1- ¹³C]leucine from the basal fractional synthetic rate of 3.63 ± 0.05%/h. In four subjects in whom infusion of tracer leucine was continued for > 1 day, aspiration of pepsin between 24 and 27 h demonstrated that plateau ¹³C labeling of leucine in pepsin had been attained, but at a value that was only 48% of the ¹³C labeling of plasma α-ketoisocaproic acid (α-KIC) [0.730 ± 0.02 (SE) vs. 1.520 ± 0.14 atoms %excess]. This suggests that actual rates of pepsin synthesis were approximately double those calculated on the basis of α-KIC labeling. The results are consistent with an interpretation that increasing doses of pentagastrin cause increased secretion of pepsinogen by recruitment of gastric chief cells, each synthesizing pepsinogen at an unaltered rate. Plateau ¹³C enrichment of α-KIC may not be a valid surrogate for plateau ¹³C leucine enrichment when fractional synthetic rates of some secreted proteins are calculated.