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

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世界糖尿病杂志:英文版(电子版) 2023年第9期14卷 1341-1348页

作者： Stefan G Pierzynowski christine stier Kateryna Pierzynowska Department of Medical Biology Institute of Rural HealthLublin 20090Poland Department of Biology Lund UniversityLund 22362Sweden Anara AB Trelleborg 23132Sweden Department of General VisceralTransplantVascularand Pediatric Surgery and Division of EndocrinologyUniversity Hospital WürzburgWürzburg 97080Germany Department of Surgical Endoscopy Sana HospitalHuerth 50354Germany Department of Animal Physiology The Kielanowski Institute of Animal Physiology and NutritionJablonna 05110Poland Anagram Therapeutics IncFraminghamMA 01701United States

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 ***,to date no exogenous or endogenous anti-incretins have been *** 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 ***,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 *** effect of alpha-amylase can be interpreted as an insulin down regulatory mechanism,possibly limiting the depletion of pancreatic beta cells and preventing their *** observations agree with the above statements,where patients with high blood alpha-amylase concentrations are seldom obese and seldom develop ***-DT2,as well as DT1 patients,usually develop exocrine pancreatic insufficiency(EPI)and vice ***,DT2 patients develop DT1,when the pancreatic beta cells are exhausted and insulin production *** 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

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