Hypothesis that alpha-amylase evokes regulatory mechanisms originating in the pancreas,gut and circulation,which govern glucose/insulin homeostasis  

作　　者：Stefan G Pierzynowski Christine Stier Kateryna Pierzynowska 

机构地区：[1]Department of Medical Biology,Institute of Rural Health,Lublin 20090,Poland [2]Department of Biology,Lund University,Lund 22362,Sweden [3]Anara AB,Trelleborg 23132,Sweden [4]Department of General,Visceral,Transplant,Vascular,and Pediatric Surgery and Division of Endocrinology,University Hospital Würzburg,Würzburg 97080,Germany [5]Department of Surgical Endoscopy,Sana Hospital,Huerth 50354,Germany [6]Department of Animal Physiology,The Kielanowski Institute of Animal Physiology and Nutrition,Jablonna 05110,Poland [7]Anagram Therapeutics,Inc,Framingham,MA 01701,United States

出　　处：《World Journal of Diabetes》2023年第9期1341-1348,共8页世界糖尿病杂志（英文版）（电子版）

摘　　要：The anti-incretin theory involving the abolishment of diabetes type(DT)II by some of methods used in bariatric surgery,first appeared during the early years of the XXI century and considers the existence of anti-incretin substances.However,to date no exogenous or endogenous anti-incretins have been found.Our concept of the acini-islet-acinar axis assumes that insulin intra-pancreatically stimulates alpha-amylase synthesis(“halo phenomenon”)and in turn,alphaamylase reciprocally inhibits insulin production,thus making alpha-amylase a candidate for being an anti-incretin.Additionally,gut as well as plasma alphaamylase,of pancreatic and other origins,inhibits the appearance of dietary glucose in the blood,lowering the glucose peak after iv or oral glucose loading.This effect of alpha-amylase can be interpreted as an insulin down regulatory mechanism,possibly limiting the depletion of pancreatic beta cells and preventing their failure.Clinical observations agree with the above statements,where patients with high blood alpha-amylase concentrations are seldom obese and seldom develop DT2.Obese-DT2,as well as DT1 patients,usually develop exocrine pancreatic insufficiency(EPI)and vice versa.Ultimately,DT2 patients develop DT1,when the pancreatic beta cells are exhausted and insulin production ceases.Studies on biliopancreatic diversion(BPD)and on BPD with duodenal switch,a type of bariatric surgery,as well as studies on EPI pigs,allow us to observe and investigate the above-mentioned phenomena of intra-pancreatic interactions.

关 键 词：PANCREAS ALPHA-AMYLASE Acini-islet-acinar axis HYPERGLYCAEMIA BARIATRICS INSULIN INCRETINS Glucosedependent insulinotropic polypeptide Glucagon-like peptide-1 Exocrine pancreatic insufficiency Pancreatic enzyme therapy Diabetes 

分 类 号：R587.1[医药卫生—内分泌]