{Reference Type}: Journal Article {Title}: A closed-loop negative feedback model for the pancreas: A new paradigm and pathway to a cure. {Author}: Dressel TD;Custer CM; {Journal}: Medicine (Baltimore) {Volume}: 103 {Issue}: 28 {Year}: 2024 Jul 12 {Factor}: 1.817 {DOI}: 10.1097/MD.0000000000038802 {Abstract}: OBJECTIVE: To develop a model that describes how the pancreas functions, how the rate of synthesis of digestive enzymes is regulated, and finally what puts the pancreas to rest between meals.
METHODS: We applied the principals of control theory to previously published canine data to develop a model for how the canine pancreas functions. Using this model, we then describe the steps needed to apply this model to the human pancreas.
RESULTS: This new closed-loop negative feedback model describes what regulates digestive enzyme synthesis. This model is based on basolateral exocytosis of butyrylcholinesterase (BCHE) into the interstitial space. It is this level of BCHE * BCHE activity that controls the rate of canine pancreas digestive enzyme synthesis, and in the absence of stimulation from the vagus nerve, puts the pancreas to rest between meals.
CONCLUSIONS: Finding secretagogue-specific inhibitory enzymes in the human pancreas that are analogous to BCHE in the canine, and blocking its associated receptors, may lead to a cure for human pancreatitis.