Neural and hormonal regulation of pancreatic secretion.

Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA.

Current opinion in gastroenterology 2009 Sep

The biology of the pancreas is exquisitely complex and involves both endocrine and exocrine functions that are regulated by an integrated array of neural and hormonal processes. This review discusses recent developments in the regulation of both endocrine and exocrine secretion from the panc reas. New data suggest that cholecystokinin can stimulate neurons located in the dorsal motor nucleus of the vagus. Addressing a controversial topic, recent evidence suggests a direct secretory action of cholecystokinin on human acinar cells. An emerging concept is that some hormones and peptides such as melatonin, ghrelin, obestatin and leptin perform dual functions in the pancreas by regulating secretion and maintaining metabolic homeostasis. The regulation of pancreatic secretion by several appetite-controlling neuropeptides such as ghrelin, orexin A and neuropeptide Y is also discussed. Recent data highlight findings that mechanisms of hormone action may be different between species possibly due to a divergence in signaling pathways during evolution. The regulation of the secretory function of the pancreas by numerous hormones suggests that there are multiple and perhaps redundant signals governing the control of this important organ. Understanding these diverse pathways is essential to the treatment of pancreatitis, diabetes and obesity.