121
PANCREAS: FUNCTIONS, DISORDERS, AND ITS PHYSIOLOGICAL ROLE IN
MAMMALIAN ORGANISMS
Sharopov Sadullo Shukurilloevich
Assistant teacher of Alfraganus University
Email: sharopovsadullo94@gmail.com
Orcid ID: 0009-0003-2585-9428
https://doi.org/10.5281/zenodo.14545661
Abstract:
This review examines scientific literature on pancreatic diseases, with a focus
on exocrine pancreatic insufficiency (EPI), and explores the relationship between pancreatic
health and obesity. It highlights the impact of pancreatic exocrine function on the
physiological development of adults and adolescents. Studies conducted on piglets, frequently
used as a model to optimize treatments for human pancreatic diseases, are also discussed. The
pancreas, performing both exocrine and endocrine functions, is a vital organ in both humans
and animals. Pancreatic diseases are often severe and challenging to manage. A well-balanced
diet and appropriate dietary supplements can significantly enhance patient well-being and
improve disease progression. Adopting a healthy diet and lifestyle plays a crucial role in
maintaining optimal pancreatic function and overall physiological efficiency.
Keywords
: pancreas, pancreatic diseases, exocrine pancreatic insufficiency (EPI),
obesity, diabetes, dietary intervention.
Introduction
The pancreas is a vital glandular organ that significantly influences the functioning of the
entire div. Pancreatic insufficiency arises when the pancreas is unable to produce or secrete
digestive enzymes in sufficient quantities to enable proper digestion and absorption of
nutrients in the intestines. This condition typically results from pancreatic damage, which can
be caused by various clinical conditions, including recurrent acute pancreatitis, chronic
pancreatitis, diabetes, autoimmune disorders, or surgical procedures like pancreatectomy. In
some cases, insufficiency is linked to pancreatic or gastrointestinal cancer. In children,
pancreatic insufficiency is most commonly associated with cystic fibrosis (affecting
approximately 90% of patients) or rare genetic disorders such as Shwachman-Diamond
syndrome.
The condition is characterized by symptoms such as malabsorption, malnutrition,
avitaminosis, and weight loss or, in children, a failure to gain weight. Treatment focuses on
addressing the underlying cause, preventing further pancreatic damage, and alleviating
symptoms.
This paper explores the impact of pancreatic dysfunction on higher mammals. Through a
comprehensive review of the literature, the role of pancreatic exocrine function in the
physiological development of adults and adolescents is examined. Key diseases affecting
pancreatic health are identified and briefly discussed. Additionally, the correlation between
pancreatic disorders and factors such as diet, lifestyle, and obesity is analyzed.
Structure of the Pancreas
The pancreas is anatomically divided into three distinct parts: the head, div, and tail
(Figure 1). The organ has a lobular parenchymal structure, comprising numerous secretory
vesicles that account for 80–85% of its mass. The pancreas's functionality is heavily reliant on
its ductal system. Each lobule contains a small duct that connects with others, ultimately
122
forming the main pancreatic duct. This primary duct originates in the pancreatic tail, extends
through the length of the organ, and empties into the duodenum via the major duodenal
papilla (Vater’s papilla).
Additionally, an accessory pancreatic duct exists in approximately 70% of individuals.
This duct typically connects with the main pancreatic duct, facilitating the transport of
pancreatic secretions to the major duodenal papilla.
The pancreas consists of two principal histological components. The pancreatic islets
(islets of Langerhans), numbering up to 2 million, produce essential pancreatic hormones. The
remaining portion of the pancreas is composed of secretory cells, which are responsible for
producing pancreatic juice and enzymes, critical for digestion and nutrient absorption. This
dual functionality underscores the pancreas's importance in both endocrine and exocrine
processes.
Physiological Functions of the Pancreas
The pancreas performs two vital functions within the div: endocrine and exocrine. The
endocrine function, carried out by the islets of Langerhans, involves the production of
hormones such as insulin, proinsulin, amylin, C-peptide, somatostatin, pancreatic polypeptide
(PP), and glucagon. Insulin plays a crucial role in lowering blood sugar levels, while glucagon
raises blood sugar levels, maintaining glucose homeostasis.
The exocrine function of the pancreas serves as a digestive gland, producing enzymes
that form part of the iso-osmotic, alkaline pancreatic juice, which facilitates food digestion in
the intestines. The enzymatic components of pancreatic juice are synthesized by acinar cells
and delivered to the duodenum via the pancreatic ducts. Additionally, goblet cells in the
pancreatic ducts secrete mucus, contributing to the juice composition. Pancreatic juice
contains enzymes for digesting proteins, fats, carbohydrates, and nucleic acids, along with
electrolytes and a small amount of mucus.
Proteolytic enzymes, such as trypsin, chymotrypsin, carboxypeptidase, and elastase, are
responsible for protein digestion. Trypsin and chymotrypsin are secreted as inactive
proenzymes, trypsinogen and chymotrypsinogen, which are activated in the intestine.
Lipolytic enzymes, including lipase, phospholipase, and esterase, digest fats, while glycolytic
enzymes, such as lactase and amylase, break down carbohydrates like starch into maltose,
maltotriose,
and
dextrins.
Nucleolytic
enzymes,
including
ribonuclease
and
deoxyribonuclease, digest nucleic acids into mono- and oligonucleotides.
The secretion of digestive enzymes is regulated by food consumption and
neurohormonal mechanisms, with the pancreas producing 1–4 liters of pancreatic juice daily,
depending on dietary intake. This coordinated endocrine and exocrine activity underscores
the pancreas's essential role in metabolism and digestion.
Influence of the Exocrine Function of the Pancreas on the Development of the
Adult and Adolescent Organism
The exocrine function of the pancreas is regulated by both the central nervous system
and hormones, with secretin and cholecystokinin (CCK) being the primary intestinal
hormones influencing pancreatic enzyme secretion (Morisset, 2020). Secretin is released by
enteroendocrine cells in the small intestine, while CCK is secreted by the duodenum and
jejunum in response to lipids and proteins in ingested food. Kapica et al. (2018) demonstrated
123
the role of obestatin, a hormone produced in specialized gastric and intestinal cells, in
modulating pancreatic juice secretion through dual mechanisms in rats.
Understanding the physiological impact of pancreatic functions on the human div has
been a longstanding area of research. The pig model is widely regarded as the most accurate
analog for human studies. Despite the absence of CCK receptors in pigs, CCK has been
identified as the main regulator of pancreatic exocrine function (Schweiger et al., 2000;
Morisset et al., 2003). Research also indicates that pancreatic development in pigs is more
influenced by dietary changes during weaning than by age (Pierzynowski et al., 1993). For
example, milk consumption in piglets triggers a postprandial glucose increase without a
corresponding rise in insulin, suggesting milk's role in regulating pancreatic enzyme
production for digestion (Pierzynowski et al., 1995).
Studies highlight a positive correlation between pancreatic exocrine function and weight
gain in suckling and young piglets (van den Borne et al., 2007; Botermans and Pierzynowski,
1999; Pierzynowski et al., 2005). Pierzynowski et al. observed an increase in exocrine
pancreatic secretion with div weight and noted higher secretion levels postprandially
compared to preprandial levels in seven out of ten tested piglets (Flegal et al., 2010).
However, pigs with exocrine pancreatic insufficiency (EPI) exhibit impaired digestion and
feed absorption, leading to slowed growth. This impact diminishes with age, as seen in studies
where EPI caused stunting in 30 kg pigs (Gregory et al., 1999) but resulted in only a 25%
growth reduction in 40 kg pigs (Corring and Bourdon, 1977).
Research by Pierzynowski et al. (1990) on the development of pancreatic exocrine
function in piglets revealed that basal pancreatic secretion and the response to feeding
remained low during the first 4–5 weeks of life. Significant increases in pancreatic juice
secretion and trypsin activity were observed only after weaning. The composition of
pancreatic juice also underwent qualitative changes during this period. Furthermore,
intravenous administration of CCK and secretin showed no stimulation of exocrine function
during the first two weeks of life, but their effects became pronounced from weeks 3 to 4.
These findings indicate that the exocrine pancreatic function and the enzymatic profile of
pancreatic juice evolve during development, with an increased hormonal response emerging
during the feeding period.
Pancreatic Exocrine Insufficiency
Exocrine pancreatic insufficiency (EPI) impairs the digestion of food by preventing the
pancreas from producing sufficient enzymes required for breaking down and absorbing
nutrients. This deficiency hinders the div’s ability to efficiently process fats, proteins,
carbohydrates, vitamins, and minerals. The damage to the pancreas leading to EPI can result
from several factors, including chronic pancreatitis, pancreatic, gastric, or intestinal surgeries,
cystic fibrosis, and Shwachman-Diamond syndrome. Additionally, conditions such as Crohn’s
disease and celiac disease can contribute to EPI in some individuals. Excessive alcohol
consumption is another significant cause, with chronic alcohol use (exceeding 80 g of ethanol
daily for 6–12 years) being a primary contributor to alcohol-induced chronic pancreatitis
(Dufour and Adamson, 2003). Clinical studies also indicate that diabetic patients are
particularly prone to developing EPI (Hardt et al., 2000, 2003).
EPI may initially be asymptomatic, but as pancreatic damage progresses and the ability
to absorb fats diminishes, symptoms such as abdominal pain, tenderness, diarrhea, gas, and a
124
sensation of fullness may appear. Other complications include weight loss, bone pain due to
vitamin D deficiency, and bleeding disorders caused by insufficient vitamin K absorption.
Diagnosis typically involves blood tests to evaluate vitamin levels and pancreatic
enzyme production. Additionally, patients may be screened for underlying conditions like
celiac disease. A "3-day stool test" can measure fat content in bowel movements, while
imaging techniques such as CT scans, MRIs, and endoscopic ultrasounds are used to detect
pancreatic inflammation.
Conclusion
The pancreas plays a critical role in processing essential nutrients to provide energy for
cellular function. Any disruption in its performance can significantly impact overall health.
Even healthy and relatively young individuals should prioritize a balanced diet and a healthy
lifestyle to maintain optimal pancreatic function over the long term.
Dysfunction of the pancreas adversely affects the div, contributing to the development
of pancreatic diseases and conditions like obesity. Similarly, unhealthy dietary habits and
poor lifestyle choices can impair pancreatic function. Chronic conditions such as obesity not
only compromise overall health but also increase the risk of developing pancreatic disorders.
Obesity, often underdiagnosed and underestimated, poses serious health risks. Effective
treatment involves a multifaceted approach, including a proper diet, physical activity, and
psychological support. The primary goals in managing obesity are improving metabolic
function and preventing associated complications. As a chronic condition, obesity requires
long-term, consistent management.
For those with exocrine pancreatic insufficiency (EPI), symptoms can be effectively
managed through the use of enzyme replacement therapies and a carefully tailored
nutritional plan. It is essential to adopt a diet rich in nutrient-dense foods while
supplementing pancreatic enzymes with every meal and snack.
A well-structured diet, customized to an individual’s specific condition, can greatly
enhance well-being and positively influence disease progression. Conversely, poorly managed
diets can exacerbate related conditions, such as diabetes, and may even pose life-threatening
risks. A pancreas-friendly diet emphasizes lean protein sources, minimizes animal fats and
simple sugars, and incorporates health-promoting ingredients to support overall health and
functionality.
References:
1.
Adler G., Kern H. F. (1975). Regulation of exocrine pancreatic secretory process by
insulin.
Horm. Metab. Res.
7 290–296. 10.1055/s-0028-1093717 [
2.
Ahima R. S. (2011). Digging deeper into obesity.
J. Clin. Invest.
121 2076–2079.
10.1172/JCI58719 [
3.
Al-Husseina A.-B. A., Tahira F. R., Pham V. T. (2021). Fixed-time synergetic control for
chaos suppression in endocrine glucose–insulin regulatory system.
Control Eng.
Pract.
108:104723. 10.1016/j.conengprac.2020.104723 [
4.
American Cancer Society Cancer (2021).
Prevention Study II (CPS-II).
Available online
https://www.cancer.org/research/we-conduct-cancer-research/behavioral-and-
epidemiology-research-group/cancer-prevention-study-2.html
April
15,
125
2021) [
5.
Bang U. C., Benfield T., Bendtsen F., Hildstrup L., Beck Jensen J. E. (2014a). The risk of
fractures among patients with cirrhosis or chronic pancreatitis.
Clin. Gastroenterol.
Hepatol.
12 320–326. 10.1016/j.cgh.2013.04.031 [
6.
Bang U. C., Benfield T., Hildstrup L., Bendtsen F., Beck Jensen J. E. (2014b). Mortality,
cancer, and comorbidities associated with chronic pancreatitis: a Danish nationwide matched-
cohort study.
Gastroenterology
146 989–994. 10.1053/j.gastro.2013.12.033 [
7.
Botermans J. A., Pierzynowski S. G. (1999). Relations between div weight, feed intake,
daily weight gain, and exocrine pancreatic secretion in chronically catheterized growing
pigs.
J. Anim. Sci.
77 450–456. 10.2527/1999.772450x [
8.
Musayeva, S. I. (2024). ADVANTAGES AND DISADVANTAGES OF INTERACTIVE
METHODS INTRODUCING THE СLT (СOMMUNIСATIVE LANGUAGE TEACHING) APPROACH.
World Scientific Research Journal, 32(1), 217-219.
9.
Bryl W., Miczke A., Pupek-Musialik D. (2005). Nadciśnienie têtnicze i otyłość –
narastający problem wieku rozwojowego.
Endokrynol. Otyłość
1 26–29. [
10.
Celiac Disease Foundation. (2021).
What is Celiac Disease?
Available online
https://celiac.org/about-celiac-disease/what-is-celiac-disease/
2021). [
