Endocrine paracrine autocrine Juxtacrine Neurocrine G cell > Gastrin nat hormone S cell > Secretin wa Serotonin + Hormone EnteroEndocrine cell naa Amine , Peptide = APUD Precursor uptake and Decarboxylase) Gastrin family secretin glucagon Secretin family glicentin Motilin @O somatostatin Substance P. guanylinmuriaianaanmavaw aa. G34 a1n Duodenum HL 15min less active Macroheterogenity\\/ G17 01n Antrum HL 2-3 min, more active G14 HL 2-3 min Metabolyte vita uaz small bowel Peptide hor. Microheterogenity | Antrum of stomach pancreas duodenum gastric a. secretion ~~ pepsin stomach sti, mucosal growth @_/ _ small bowel 4} GI motility \ sti, ECL cell na Histamine \ + insulin secretion (iaugnnsvquarn Prot.’ CHO-sti-insulin ww dn pathway Peptide, aa. (phy.tryp) gastric distention Gastrin Neuro: Vagus n. via GRP Regulation \ Epinephrine | Blood Secretin, GIP, Calcitonin, VIP, glucagon \ ( inh. G cell Savato | Luminal Acid ~~ sti. D cell > somatost: inh_Parietarcell natinsa somatostatin \ if Parietal cell damage >> low H+ >> can't inh Gastrin > castrinsimilar to Gastrin Structure Same 5 aa. @ C-terminal duodenum Secreted by _tesllocste@ jejunum ? relax Sphincter of Oddi secrete Pancreatic enz. / s gastric emptying 4 effect of Secretin a9 Alkaline Trophic effect on pancreas secrete enterokinase motility of small bowel & colon 4 tension Pyloric sphincter \ 4B Gtucagon secretion (+Gastrin) Hypothalamus "di" @brain @periphery bind to cell receptor ‘ = CCKB_ @brain \ eck 8 | | | Sn by activate > phospholipase C > IP3,DAG \ _ < ce) CCK-A \\ Pancreatic enz. fatty a Lipid _/_monoglycerol ( Ac Stimulators — Peptone I \ i fp enz. fatty a Positive feed back | Control of CCK secretion \ "CCK-RP" from dudenum | | “monitor Peptide” from pancreatic acinar cell [atta Pent tom poner acrarcst | digest fat, protein \ Sti, by \ ~~~ neural inpiut (cephalic phase! cCK-RP — ipiut (cep! phase) . secrete CCK \\ sip Receptor \—* pancreatic enz. Aa IWISAANIA Trypsin maaan qnuauau Trypsin CCK-RP Su%aignuan > Sti. CCKStructure __27 aa. (1 form) Duodenum secrete by __S cell @ mucosal gland jejunum HCO3 secrete sti, Pancreas Fluid (water > wid?aanndu) Action wu cAMP. 4B CHO (satu CCK way Ach) 3S Gastrin secrete Pyloric schincter contraction | sti. growth of exocrine pancreas (+11 CCK) vhost glucagon, VIP dis Receptor > cAMP [> CFTR "Cl- Channel" (Cystic fibrosis transmembrane regulator) transport Cl- to lumen CLICHO3 counter transport \\ CHOS secrete wan Cl- 127 cell aw gradient prot. digestive product bile acid sti.by /~ \_fatty food \\ acidity (pH <4.5) somtostatin Control of Secretin inh. by Metenkephalin \. secretin -Releasing peptide42 aa. polypeptide duodenum a K cell@ if { jejunum 4} Gastric motility (Mild) [_ inh. gastric acid secretion inh. naunsa Parietal cell inh. gastrin release 01n G cell (via somatostatin) (2 sti. nab insulin o1n pancreatic islet \C fw glucose sti. insulin “Yaginna IV Mech. of Action glucose & fat in duodenum \ sti, by acid in stomach Control of GIP eS DPP-IV (dipeptidy!-peptidase IV) \ inactivated by_—DPPTY (eipeptidyt peptidase IV) —————<_ tu many tissue/portal circulation Alpha cell of pancreatic islet glycogenolysis, _Sluconeogenesis _ siaaa1n Glucagon-Like Peptide 1 30 aa. polypeptide structure | intestinal hor. “Incretin hormone” _ | stiinsulin secrete SSS | Leal @ Pancreatic alpha cell __ Produced by _\ GLP-1 hypothalamus, pituitary gl. _/ ifimainnaseaaw Proglucagon J Gastric emptying “+ | insulin synthesis & secrete ‘jj ‘\ | Action glucagon secrete Beta cell proliferation 69 aa. peptide (sfaura1n Proglucagon) Secretes from L cell (waauris GLP-1) sti_inslin secretion wc ack ion» inh. gastric acid secretion _ Action regulate gut motility sti intestinal growth _/ Produced by Glucagon blood glucose byEnteric neural system /aatete neural syste 28 aa. neurocrine wut brain \ autonomic nee | esophagus | distension of pen stomach | | _ Vagal sti Release in response to | fatty a | \ ethanol in duodenum \_ 36 Amino a. , glucose Half life 2 min water & E'lyte secretion in small bowel Circular Sm Mus relaxation eee longitudinal Sm Mus contraction pancreatic secretion gastric secretion and motility K t Action of Ach in salivery gland ViPoma >> Profused Diarrhea 22 aa polypeptide duodenum Mcell Secreted by {jejunum +. \\ Enterochromaffin cell_- Ce se ‘ecretin fai 2 _MMC 90-100 min_ Motilin ) Action _via G-prot. coupled receptor _inh. by ingestion _ \Gentol su by vagus n \ sti \Gentol su by vagus n vagus n. \ \ \ Ju Motiin (R) \ Target of Erythromycin . . \ Wath side eff Hnaidu \ Growth hormone inhibitory hormone stomach | secreted by __Dcell@ / duodenum | pancreatic islet secreted in lumen > circulation Sear in men > creulation (gastrin, VIP,GIP,secretin, Gihormone_/ _ motilin,GH Somatostatin - \\ insulin glucagon) | Pe tuid absoro a pancreatic secretion gall bladder contraction \ SB gastric secretion & motility \ \ db Absorb glucose,amino a., TS \. released in response to acid in stomach \ Actionuu "Vin" feeding center lateral (n) quis "du" Satiety center__ ventromedial (n) ‘Ju Receptor MCR = inh. PVN paraventricular (n) = PVN { (du NPY1 receptor = sti, PVN POMC / CART (n) #89 &-MSH ° Hypothalamus Arcuate (n) U NPY / AGRP (n) YY NPY’ Anorexigenic eff. Eff. of Gl hormone on "3" __fesponse to Calories _ \ direct __ hypothalamus rect “pt insulin Orexigenic eff. ( _Ghrelin_ [ Eff. of GI hormone on "Vi" | Neuropeptide Y Wn vs aN ore \ Ghrelin Neuropeptide Orexin neuron in posterolateral Hypothalamus Seen neuron in posterolateral Hypothalamus _ aan _Orexin A (33aa.) #4 BBB 2 type —<_Orexin B (28aa.) via G-prot couple receptor Orexins / mnpocrat | Action du OxR2 | \ ae eouaw "v2" Receptor faye erway Metabolism via Vagus(sensory pathway) Atma / meas hypoglycemia \ \ inh, by msfinaanis28 aa. peptide secreted by __oxyntic cell in gastric fundus // pancreas | intestine || _founa in hypothalamus pituitary gt duriv Receptor a "wth Hor, -secretagogue-receptor 1a(GH! | _via G-prot. coupled receptor |[ ‘ii sli NPYIAGRP neuron (in Arcuate neu) t astric acid & motili Gastric eff. g Ny Action via Vagus | sti. GH secretion (Sawriu GHRH) | ( 4} somatoatatin from hypothalamus 4 ACTH, PRL, cortisol inh, Proinflammatory cytokines(|L-1, IL-6, TNF) Physio. eff. bone density \ mean Bpby TP 41-2 hr before meal [MAX @ eating 1 hr after meal inh, by Calories (Carbo. > fat) \C sti. by amino a leptin showaitaiwa ns | (HR thyroid 4B ghrelin Testosterone Factors \C Anorexia nervosa food intake | glucosellipid / Insulin ghrelin somatostatin \_ PYYIPP \. hi BMIduodenum(more common) Gastrinoma Pancreas hypergastrinemia triad severe peptic ulcer PU refactory to treatment | muttiple ulcers ulcer in distal part duodenum, jejunum GERD Zollinger-Ellison syndrome diarrhea, steatorrhea weight loss \ vit 812 malabsorption una &a Secretin > Gastrin an. Secretin inhibitory test ( | tity > Gastrin “aian inmeaswarniavanviagindansaquay benign pancreatic tumor malignant | Diabetes (Hyperglycemia a1n glucagon) | [Dermatitis (necrolytic migratory erythema) Glucagonoma DVT (deep vein thrombosis) _DVT (deep vein thrombosis) _ Cow \._ S&S "4D" \__ Depression \ Diarrhea \. Weight loss