NEUROHUMORAL CONTROL OF THE EXOCRINE PANCREAS

This review includes discussions on recent advances in neurohumoral in teractions that emphasize important neuronal roles in the actions of g ut hormones, roles of neuropeptides and nitric oxide, feedback regulat ion of the exocrine pancreas, and physiologic significance of insulo-a cinar axis. The actions of gut hormones on the exocrine pancreas in ph ysiologic conditions are mediated mainly via either vagal sensory affe rent or vagal efferent cholinergic pathways, or a central vagal site. Neuropeptides appear to exert their actions on the pancreas, not direc tly on acini; they are mediated via releases of hormones or via neuron al pathways. In feedback regulation of the exocrine pancreas, pancreat ic proteases in gut lumen control the release of cholecystokinin and s ecretin, thereby controlling pancreatic secretion. Lastly, the local m ediation of insulin in the exocrine pancreas is essential for the acti ons of cholecystokinin and secretin on the exocrine pancreas.