Gastrointestinal tract secretions

The somatostatin analogue, D-Phe-c(Cys-Tyr(I)-D-Trp-Lys-Val-Cys)-Thr-NH2 containing a Tyr phenyl ring iodinated in the 3- or 5-position was prepared by Gordon (1) and was effective in inhibitory excess pituitary, pancreas, and gastrointestinal tract secretions. 

Secretion. Secretion of substances, such as acid, pepsin, bile, and enzymes, is necessary to digest nutrients. In addition to the digestive material, the gastrointestinal tract secretes hormones and paracrine substances that modulate the function of other cells. 

Metabolism—It is noteworthy (1) that vitamin B-12 is the only vitamin that requires a specific gastrointestinal tract secretion for its absorption (intrinsic factor) and (2) that the absorption of vitamin B-12 in the small intestine requires about 3 hours (compared to seconds for most other water-soluble vitamins). The absorption of vitamin B-12 involves the following five steps ... 

The absorption of sulfonylureas from the upper gastrointestinal tract is faidy rapid and complete. The agents are transported in the blood as protein-bound complexes. As they are released from protein-binding sites, the free (unbound) form becomes available for diffusion into tissues and to sites of action. Specific receptors are present on pancreatic islet P-ceU surfaces which bind sulfonylureas with high affinity. Binding of sulfonylureas to these receptors appears to be coupled to an ATP-sensitive channel to stimulate insulin secretion. These agents may also potentiate insulin-stimulated glucose transport in adipose tissue and skeletal muscle. 

Pituitary Adenylyl Cyclase-activating Polypeptide (PACAP) is a 38-amino acid peptide (PACAP-38), which is widely expressed in the central nervous system. PACAP is most abundant in the hypothalamus. It is also found in the gastrointestinal tract, the adrenal gland and in testis. Its central nervous system functions are ill-defined. In the periphery, PACAP has been shown to stimulate catecholamine secretion from the adrenal medulla and to regulate secretion from the pancreas. Three G-protein coupled receptors have been shown to respond to PACAP, PAQ (PACAP type I) specifically binds PACAP, VPACi and VPAC2 also bind vasoactive intestinal peptide (VDP). Activation of PACAP receptors results in a Gs-mediated activation of adenylyl cyclase. 

Gastrointestinal tract Inhibition of most gut hormones, gastric acid, pepsin, bile and colonic fluid secretion... 

Vasoconstriction of peripheral blood vessels Regulates release of neurotransmitters decreases tone, motility, and secretions of gastrointestinal tract Increased heart rate, increased force of myocardial contraction... 

Gastrointestinal tract-decrease in secretions of the stomach, decrease in gastric and intestinal movement (motility)... 

This occurs in the seromucous secretions such as saliva, tears, nasal secretions, sweat, colostrum and secretions of the lung, urinogenital and gastrointestinal tracts. Its purpose appears to be to protect the external surfaces of the body from microbial attack. It occurs as a dimer in these secretions but as a monomer in human plasma, where its function is not known. The function of IgA appears to be to prevent the adherence of microorganisms to the surface ofmucosal cells thus preventing them entering the body tissues. It is protected from proteolysis by combination with another protein—the secretory component. 

There are a number of side-effects of opiates that are due to their actions on opiate receptors outside the central nervous system. Opiates constrict the pupils by acting on the oculomotor nucleus and cause constipation by activating a maintained contraction of the smooth muscle of the gut which reduces motility. This diminished propulsion coupled with opiates reducing secretion in the gut underlie the anti-diarrhoeal effect. Opiates contract sphincters throughout the gastrointestinal tract. Although these effects are predominantly peripheral in origin there are central contributions as well. Morphine can also release histamine from mast cells and this can produce irritation and broncho-spasm in extreme cases. Opiates have minimal cardiovascular effects at therapeutic doses. 

Resins are moderately effective in lowering LDL cholesterol but do not lower triglycerides (Table 9-8). Moreover, in patients with elevated triglycerides, the use of a resin may worsen the condition. This may be due to a compensatory increase in HMG-CoA reductase activity and results in an increase in assembly and secretion of VLDL. The increase in HMG-CoA reductase activity can be blocked with a statin, resulting in enhanced reductions in serum lipids (see section on combination therapy). Resins reduce LDL cholesterol from 15% to 30%, with a modest increase in HDL cholesterol (3% to 5%) (Table 9-8). Resins are most often used as adjuncts to statins in patients who require additional lowering of LDL cholesterol. Since these drugs are not absorbed, adverse effects are limited to the gastrointestinal tract (Table 9-9). About 20%... 

Ulcer formation is the net result of a lack of homeostasis between factors within the gastrointestinal tract responsible for the breakdown of food (e.g., gastric acid and pepsin) and factors that promote epithelial defense and repair (e.g., bicarbonate, mucus secretion, and prostaglandins). 

During normal processes, approximately 9 liters of fluid traverse the gastrointestinal tract daily. Of this amount, 2 liters represent gastric juice, 1 liter is saliva, 1 liter is bile, 2 liters are pancreatic juice, 1 liter is intestinal secretions, and 2 liters are ingested. Of these 9 L of fluid presented to the intestine, only about 150 to 200 mL remain in the stool after reabsorptive processes occur. 

Caffeine stimulates gastric secretion. Other factors in coffee besides caffeine also cause increase gastric secretion. This is probably the most striking effect of coffee on the gastrointestinal tract. 

The gastrointestinal tract (GIT) is a highly specialized region of the body whose primary functions involve the processes of secretion, digestion, and absorption. Since all nutrients needed by the body, with the exception of oxygen, must first be ingested orally, processed by the GIT, and then made available for absorption into the bloodstream, the GIT represents a significant barrier and interface with the environment. The primary defense mechanisms employed by the gut... 

Prostaglandins play critical roles in a number of physiological processes. These molecules regulate blood flow to organs, stimulate secretion of protective mucosal linings in the gastrointestinal tract, participate in the initiation of platelet aggrega-... 

The final mechanism of action of PTH involves the activation of vitamin D3 through the stimulation of la-hydroxylase in the kidney. In the gastrointestinal tract, vitamin D3 is essential for the absorption of calcium. Enhanced absorption of calcium from dietary sources serves to further increase the concentration of calcium in the blood. Many foods, in particular, dairy products, which are rich in calcium, are fortified with vitamin D. The release of PTH from the parathyroid glands is regulated by plasma calcium levels through negative feedback. A decrease in the level of calcium in the blood stimulates the secretion of PTH and an increase in the calcium level in the blood inhibits it. 

The accessory digestive organs exist outside the gastrointestinal tract however, each of these organs empties secretions into the tract that contribute to the process of digestion. These accessory digestive organs include ... 

In the periphery, 5-HT4 receptor mRNA is found in vascular smooth muscle. Newly developed drugs that activate 5-HT4 receptors are of interest for their potential in treating cardiac arrhythmia. The 5-HT4 receptor is also located on neurons of the alimentary tract, for example the myenteric plexus of the ileum, and on smooth muscle cells and secretory cells of the gastrointestinal tract, where they evoke secretions and the peristaltic reflex. 5-HT4 receptor agonists (e.g. cisapride, prucalopride, tegaserod) are used therapeutically in the treatment of constipation-predominant irritable bowel syndrome and in functional motility disorders of the upper gastrointestinal tract. 

In a normal human adult, about 2 g of zinc is filtered by the kidneys daily and about 0.3 to 0.6 mg is actually excreted each day (Goyer 1986). Zinc homeostasis in rats, unlike most mammals, is maintained by zinc secretion from the intestines rather than by regulation of zinc absorption (Elinder 1986). Initial uptake of zinc from the rat gastrointestinal tract involves binding to albumin and transport of the zinc-albumin complex from intestine to liver (Hoadley and Cousins 1988). 

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