The Pepsinogens are gastric acid protease zymogens. They are divided into two distinct immunochemical groups: Pepsinogen I and II. Pepsinogen I is produced primarily in the Oxyntic gland mucosa of the stomach. It is secreted mainly into the gastric lumen and into circulation. Pepsinogen I has little or no biological activity but in acid is converted to the active enzyme Pepsin which exhibits proteolytic actions. Pepsinogen I is cleared by the kidney and secreted into the urine. Patients with pernicious anemia and gastrectomized patients have low to non-detectable levels of Pepsinogen I. Pepsinogen I levels are slightly elevated in gastric ulcer, higher in gastroduodenal ulcer and significantly elevated in duodenal ulcer. Patients with Zollinger-Ellison’s syndrome exhibit greatly elevated levels. Pepsinogen I has been shown to correlate with presence of genetic duodenal ulcer, and has been used as a subclinical marker of increased risk for stomach cancer.
Serum/Plasma: 24 – 214 ng/ml
Pepsinogen I is measured by direct EIA/ELISA.
Patient should be fasting 10 – 12 hours prior to collection of specimen. Antacids or other medications affecting stomach acidity or gastrointestinal motility should be discontinued, if possible, for at least 48 hours prior to collection.
3 ml serum or EDTA plasma should be collected and separated as soon as possible. Freeze specimens immediately after separation. Minimum specimen size is 1 ml.
For tumor/tissue and various fluids (i.e. CSF, peritoneal, synovial, etc.) contact the Institute for requirements and special handling.
Ship specimens frozen in dry ice.
1. M Plebani, F DiMauro, PL Dal Santo. D Faggian, B Germana, and F Vianello. Measurement of Pepsinogen Group I in Endoscopic Gastroduodenal Biopsies. Clinical Chemistry 36: 682-684, 1990.
2. IM Samloff and WM Liebmann. EIA/ELISA of Group I Pepsinogens in Serum. Gastroenterology 66: 494, 1974.