Neurohormonal control of the exocrine pancreas

This review updates the progress made in the mechanism of neurohormonal regulation of the exocrine pancreas. Two different cholecystokinin-releasing peptides were found, one from rat intestinal perfusate composed of 70 to 75 amino-acid residues and another from porcine intestinal mucosa that was identical to porcine diazepam binding inhibitor(1-86). A secretin-releasing peptide in rat intestinal perfusate and three luminal releasing peptides have also been identified. In addition, a secretin-releasing peptide was found in canine pancreatic juice and had 100% homology with canine pancreatic phospholipase A(2). The release and action of these peptides from proximal intestine are regulated by the autonomic nervous system, submucosal, and enteric nervous system. Functional-morphologic evidence of enteropancreatic reflex was provided, and a sensitizing effect of ethanol on pancreatic acinar cells led to increased zymogen conversion in response to cholecystokinin. The latter observation may turn out to be an important first step in the pathogenesis of alcohol-associated pancreatitis.