Enteropancreatic Axis

Abstract

The pancreas houses insulin, the most powerful known metabolic regulator. In addition to the β cell, Langerhan’s pancreatic islets also contain D cells producing somatostatin, a cells producing glucagon and PP cells producing pancreatic polypeptide (Fig. 1). Between them these cells have the power to stimulate or suppress numerous physiological functions. A major and frequent challenge to the constancy of the “milieu intérieur” is the daily ingestion of food. The smooth assimilation of oral nutriments requires an efficiently controlled digestive process and a precise adjustment of metabolic regulators. To this end a complicated control system exists. This is partly neural, thus allowing an early flow of information from the anticipation, smell and taste of food, and partly hormonal, utilising the diffuse endocrine system of the gut to produce an integrated signal proportional to the amount and type of food ingested. Only if the first two mechanisms fail to fully adjust metabolic regulators, such as pancreatic insulin, would a significant disturbance of circulating nutriments occur and stimulate the pancreatic islets directly.