Characterization of urinary peptic activity after total gastrectomy.

Urinary peptic activity, which has always been thought to originate from only the gastric mucosa, was detected in 26 of 50 totally gastrectomized patients with a mean value of 167 +/- 30 ng/ml. The gel filtration analysis suggested that the peptic activity of urine after total gastrectomy was detected at the same fractions as those of pepsinogens. Moreover, electrophoretical analysis of urine after total gastrectomy showed that the peptic activity was detected at the same distance as that of group I pepsinogen. The immunoreactive pepsinogen I in the urine and serum was then examined by radioimmunoassay. Pepsinogen I was detected in the urine of all the patients who had undergone total gastrectomy, the mean value of urinary pepsinogen I being 32.2 +/- 3.83 ng/ml. In 38 of 40 cases, pepsinogen I was detected in the serum at a mean value of 4.17 +/- 0.51 ng/ml. Moreover, the peptic activities and immunoreactive pepsinogen I levels in the urine correlated well. These results suggested that urinary peptic activities detected after total gastrectomy were due to the pepsinogen I previously believed limited to the gastric mucosa. The extra-gastric production of pepsinogen I was therefore strongly suggested.