The Pepsinogens are gastric acid protease zymogens. They are divided into two distinct immunochemical groups. Pepsinogen I and II. Pepsinogen II is one of 4 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.

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.

Gold serum separator (SST) tube

Immediately following collection, mix sample by gently inverting 5 times

1. Allow sample to clot for a minimum of 30 minutes
2. Spin within two (2) hours of sample collection
3. Transfer serum to a Screw-cap polypropylene frozen transport vial/tube - 4mL (LabCorp), labelled as serum
4. Freeze

Screw-cap polypropylene frozen transport vial/tube - 4mL (LabCorp)

Red serum vial/tube - 5 mL

1. Allow sample to clot 
2. Spin within two (2) hours of sample collection
3. Transfer serum to a Screw-cap polypropylene frozen transport vial/tube - 4mL (LabCorp), labelled as serum
4. Freeze

Frozen

Direct EIA/ELISA

≤ 22 ng/dL