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Review
. 2024 Feb 19;13(4):1179.
doi: 10.3390/jcm13041179.

Interactions between the Exocrine and the Endocrine Pancreas

Roberto Valente  1   2 , Alessandro Coppola  3 , Chiara Maria Scandavini  1 , Asif Halimi  1 , Annelie Magnusson  1 , Augusto Lauro  3 , Ira Sotirova  1 , Urban Arnelo  1 , Oskar Franklin  1   2
Affiliations
Review

Interactions between the Exocrine and the Endocrine Pancreas

Roberto Valente et al. J Clin Med. .

Abstract

The pancreas has two main functions: to produce and secrete digestive enzymes (exocrine function) and to produce hormones that regulate blood glucose and splanchnic secretion (endocrine function). The endocrine and exocrine portions of the pancreas are central regulators in digestion and metabolism, with continuous crosstalk between their deeply interconnected components, which plays a role in disease. Pancreatic neoplasms, inflammation, trauma, and surgery can lead to the development of type 3c diabetes when an insult simultaneously damages both acini and islets, leading to exocrine and endocrine dysfunction. In diabetes mellitus patients, pancreatic exocrine insufficiency is highly prevalent, yet little is known about the associations between diabetes mellitus and pancreatic exocrine function. This review aims to provide an overview of the physiology of the pancreas, summarize the pathophysiology and diagnostic work-up of pancreatic exocrine insufficiency, and explore the relationships between exocrine pancreatic insufficiency and diabetes mellitus.

Keywords: chronic pancreatitis; diabetes; interactions; pancreas physiology; pancreatic endocrine insufficiency; pancreatic exocrine insufficiency.

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Conflict of interest statement

Dr. Arnelo is co-PI of a Boston Scientific-sponsored study of the use of intra-operative pancreatoscopy in IPMN patients. Dr. Arnelo is a consultant for Boston Scientific and Ambu. Dr. Valente is a consultant for Boston Scientific. The other authors declare no conflicts of interest.

References

    1. Gavaghan M. The pancreas–hermit of the abdomen. AORN J. 2002;75:1110–1114, 1117, 1119 passim; quiz 1131–1132, 1134–1135, 1137–1138. doi: 10.1016/S0001-2092(06)61613-X. - DOI - PubMed
    1. Mastracci T.L., Apte M., Amundadottir L.T., Alvarsson A., Artandi S., Bellin M.D., Bernal-Mizrachi E., Caicedo A., Campbell-Thompson M., Cruz-Monserrate Z., et al. Integrated Physiology of the Exocrine and Endocrine Compartments in Pancreatic Diseases: Workshop Proceedings. Pancreas. 2022;51:1061–1073. doi: 10.1097/MPA.0000000000002170. - DOI - PMC - PubMed
    1. Alexandre-Heymann L., Mallone R., Boitard C., Scharfmann R., Larger E. Structure and function of the exocrine pancreas in patients with type 1 diabetes. Rev. Endocr. Metab. Disord. 2019;20:129–149. doi: 10.1007/s11154-019-09501-3. - DOI - PubMed
    1. Foster T.P., Bruggeman B., Campbell-Thompson M., Atkinson M.A., Haller M.J., Schatz D.A. Exocrine Pancreas Dysfunction in Type 1 Diabetes. Endocr. Pract. 2020;26:1505–1513. doi: 10.4158/EP-2020-0295. - DOI - PMC - PubMed
    1. Anagnostides A., Chadwick V.S., Selden A.C., Maton P.N. Sham feeding and pancreatic secretion. Evidence for direct vagal stimulation of enzyme output. Gastroenterology. 1984;87:109–114. doi: 10.1016/0016-5085(84)90132-X. - DOI - PubMed

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