title: [Influence of the extrinsic nervous system on exocrine pancreatic secretion in the human].
abstract: Exocrine pancreatic secretion is regulated by gastrointestinal hormone and the autonomic nervous system. The interaction of both systems is still unclear. In humans CCK mediated regulation of exocrine pancreatic secretion requires a cholinergic tonus. The CCK receptor is thought to be localized on the acinuscell and modulated by cholinergic neurons. Pancreas transplantation and percutaneous diversion of the pancreatic juice offers the opportunity to investigate pancreatic secretion under the condition of complete extrinsic denervation. In the present study the influence of denervation on exogene CCK stimulation and simultaneous cholinergic stimulation or suppression with atropine, respectively, was investigated. CCK stimulation alone showed a reduced, dose dependent increase in enzyme secretion. Simultaneous stimulation with bethachenol resulted in a 2-fold increased secretion. Atropine suppressed the low dose CCK effect completely. Whereas CCK at high doses caused a 1.5 fold increase despite atropine. After extrinsic denervation the human pancreas remains sensitive to exogene stimulation. The intrinsic system remains also intact and is sensitive to cholinergic stimulation. The extrinsic nervous system seems to be necessary for an adequate CCK response. The results are in line with the hypothesis that CCK receptors are only partly localized on the acinuscell, whereas the majority is localized in extrinsic cholinergic neurons.
mesh_terms: D000328:Adult; D001285:Atropine / Q000494:pharmacology; D018723:Bethanechol / Q000494:pharmacology; D002108:Ceruletide / Q000494:pharmacology; D002766:Cholecystokinin / Q000502:physiology*; D002799:Cholinergic Fibers / Q000187:drug effects / Q000502:physiology*; D003714:Denervation; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000294:innervation*; D016035:Pancreas Transplantation / Q000502:physiology*; D010189:Pancreatic Juice / Q000378:metabolism*; D012633:Secretin / Q000502:physiology*; D012636:Secretory Rate / Q000187:drug effects
chemical_list: D018723:Bethanechol; D012633:Secretin; D001285:Atropine; D002108:Ceruletide; D002766:Cholecystokinin