Clinical Significance:
The Pepsinogens are gastric acid protease zymogens. They are divided into two distinct immunochemical groups: Pepsinogen I and II. Pepsinogen II is one of four aspartic proteinases: PG I, PG II, Cathepsin E and D. Pepsinogen II is produced primarily in the Oxyntic gland mucosa of the stomach, the gastric antrum and the duodenum. It is secreted mainly into the gastric lumen and into circulation. Pepsinogen II has little or no biological activity but in acid is converted to the active enzyme Pepsin which exhibits proteolytic actions. Unlike Pepsinogen I, Pepsinogen II is not normally found in the urine. Patients with pernicious anemia have low to non-detectable levels of Pepsinogen I but normal levels of Pepsinogen II. Pepsinogen II levels are slightly elevated in gastric ulcer. Patients with Zollinger-Ellison’s syndrome exhibit greatly elevated levels.
Reference Range:
Up to 22 ng/ml
Procedure:
Pepsinogen II is measured by direct EIA/ELISA.
Patient Preparation:
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.
Specimen 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.
Special Specimens:
For tumor/tissue and various fluids (i.e. CSF, peritoneal, synovial, etc.) contact the Institute for requirements and special handling.
Shipping Instructions:
Ship specimens frozen in dry ice.
References:
1. M Plebani, M Masiero, F DiMauro, A Boniolo, and A Burlina. EIA/ELISA for Pepsinogen C. Clinical Chemistry 36: 1690, 1990.
2. S Matzkum, M Zoller, and W Rapp. Radioimmunological Quantification of Human Group-II Pepsinogens. Digestion 18: 16, 1978.