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Pepsinogen I in the blood
Medical expert of the article
Last reviewed: 05.07.2025
Reference values (norm) for pepsinogen I concentration in blood serum are 28-100 μg/l (28-100 ng/ml).
The chief cells of the gastric glands synthesize and secrete pepsinogens, which are divided into 2 groups according to immunochemical characteristics. Seven fractions of pepsinogen have been identified in the blood serum, 5 of which constitute the pepsinogen I group, 2 constitute the pepsinogen II group. Pepsinogen I is a precursor of pepsin, produced mainly by the chief cells of the glands of the body of the stomach. A small portion of pepsinogen I enters the blood, where its concentration is 6 times higher than that of pepsinogen II. Normally, pepsinogen I is found in the urine. The level of pepsinogen secretion into the lumen of the stomach is determined by the number of chief cells and is controlled by gastrin.
The serum pepsinogen I level or the pepsinogen I/pepsinogen II ratio reliably reflects the number of main cells of the gastric glands in the body region, i.e. the degree of atrophy of the gastric body mucosa. As the severity of atrophic gastritis of the gastric body increases, the pepsinogen I level and the pepsinogen I/pepsinogen II ratio decrease. There is a positive correlation between gastric secretion of hydrochloric acid and the serum pepsinogen I level, on the basis of which the measurement of the latter serves as a method of indirect or probeless assessment of gastric acidity.
In diseases associated with increased secretory function of the stomach, the concentration of pepsinogen I in the blood serum may increase, on the contrary, with a decrease in the number of main cells of the gastric glands, it decreases. A linear correlation is observed between the loss of the main cells of the gastric glands caused by atrophy of the mucous membrane and the level of pepsinogen I. The concentration of pepsinogen I in the blood serum below 25 μg / l has 78% sensitivity and 98% specificity for the diagnosis of atrophic gastritis of the body of the stomach (moderate and severe). Simultaneous detection of low concentrations of gastrin 17 and pepsinogen I in the blood serum guarantees 100% specificity in the diagnosis of atrophic gastritis. Low concentration of pepsinogen I in the blood serum is also characteristic of pernicious anemia.
Elevated concentrations of pepsinogen I in the blood serum are observed in hypergastrinemia ( Zollinger-Ellison syndrome, duodenal ulcer,acute gastritis ).
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