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Intervention of GI neuropeptides in pancreatic growth and regeneration: comparison with cholecystokinin

100%

Morisset J.

nr 4

127-141

The pancreatic gland has an enormous potential for growth and regeneration, mainly in rodents. These processes remain mostly under the control of the GI hormone cholecystokinin (CCK). The human pancreas however does not show proliferative properties after partial pancreatectomy, but research in this field has been scarce. Recent studies indicate that CCK might not be the expected trophic agent since its two receptors CCKA and CCKB were not found on human exocrine pancreas. Therefore, if human pancreas grows and regenerates, it has to be under the influence of some unknown trophic factors. Neuropeptides receiving much attention lately as regulators of pancreatic functions could be among the searched trophic agents. This presentation focusses on neuropeptides growth potential: GRP-Bombesin, GABA, PP, PYY, Neurotensin, SP, VIP, PACAP, CGRP and galanin. Some neuropeptides have moderate effects on pancreatic enzymes and electrolytes secretion: SP, VIP, PACAP. However, their trophic effects remain unexplored except for GRP-bombesin and PACAP. PACAP preferentially exhibits its mitogenic and proliferative effects on the pancreatic acinar cells AR4-2J via tyrosine kinase, phospholipase D and ornithine decarboxylase activation but not through adenylate cyclase. The growth promoting action of GRP-bombesin is well documented on rodent's pancreas. However, recent studies indicate that this neuropeptide is potentially trophic for larger mammals' pancreas. Indeed, investigators recently documented that bombesin induced pancreatic regeneration in the pig after partial pancreatectomy through mitogen-activated protein kinases activation as do CCK-8 and caerulein on rat pancreas. Have we found the magic pancreatic trophic factor in large mammals? Further investigations will tell.

Studying the post-operatory and molecular modifications in the chronic pancreatitis and pancreatic cancer - The Importance of the micronutrients and pancreatic enzyme supplementation

80%

Timofte D. , Bintintan V. , Munteanu I. , Blaj M. , Anton E. , Ciobica A. , Surlin V.

tom 47

The pancreatic cancer is a disorder with an exponentially increased incidence, especially over the last few years. Moreover, it is estimated that almost 95% of the patients with this disease are presenting to the hospital in the advanced and unresectable stages. Also, over the past few decades the development and advance of the surgical methods and techniques have improved, with the most of the operatory actions in the chronic pancreatitis and pancreatic cancer being represented by the whipple duodeno-pancreatectomy, which in fact represents the standard resection for tumors of the duodenum, as well as the hepatopancreatic ampulla of Vater, distal choledocus and the head of the pancreas. Moreover, it is important to mention that in these cases, after an extended resection and reconstruction of the upper gastrointestinal tract, the digestive physiology will be disrupted. In addition, previous studies have shown that patients can maintain a body mass index after surgery but often this will be lower than its preoperative value. Thus, considering the aforementioned aspects, in the present mini-review we were mainly interested in presenting also the relevance of the micronutrients such as iron, selenium, vitamin D and E, zinc or copper in this complicated area of research, as well as aspects regarding the correlations between immune function and micronutrients or the pancreatic enzyme supplementation.