Localization of pancreatic polypeptide cells in a limited lobe of the human neonate pancreas: remnant of the ventral primordium?

Paracrine and autocrine control of insulin secretion in human islets: evidence and pending questions

Insulin secretion by β-cells is largely controlled by circulating nutrients, hormones, and neurotransmitters. However, recent years have witnessed the multiplication of studies investigating whether local regulation also takes place within pancreatic islets, in which β-cells cohabit with several other cell types. The cell composition and architectural organization of human islets differ from those of rodent islets and are particularly favorable to cellular interactions. An impressive number of hormonal (glucagon, glucagon-like peptide-1, somatostatin, etc.) and nonhormonal products (ATP, acetylcholine, γ-aminobutyric acid, dopamine, etc.) are released by islet cells and have been implicated in a local control of insulin secretion. This review analyzes reports directly testing paracrine and autocrine control of insulin secretion in isolated human islets. Many of these studies were designed on background information collected in rodent islets. However, the perspective of the review is not to highlight species similarities or specificities but to contrast established and speculative mechanisms in human islets. It will be shown that the current evidence is convincing only for a minority of candidates for a paracrine function whereas arguments supporting a physiological role of others do not stand up to scrutiny. Several pending questions await further investigation.

The role of pancreatic polypeptide in the regulation of energy homeostasis

Imbalances in normal regulation of food intake can cause obesity and related disorders. Inadequate therapies for such disorders necessitate better understanding of mechanisms that regulate energy homeostasis. Pancreatic polypeptide (PP), a robust anorexigenic hormone, effectively modulates food intake and energy homeostasis, thus potentially aiding anti-obesity therapeutics. Intra-gastric and intra-intestinal infusion of nutrients stimulate PP secretion from the gastrointestinal tract, leading to vagal stimulation that mediates complex actions via the neuropeptide Y4 receptor in arcuate nucleus of the hypothalamus, subsequently activating key hypothalamic nuclei and dorsal vagal complex of the brainstem to influence energy homeostasis and body composition. Novel studies indicate affinity of PP for the relatively underexplored neuropeptide y6 receptor, mediating actions via the suprachiasmatic nucleus and pathways involving vasoactive intestinal polypeptide and insulin like growth factor 1. This review highlights detailed mechanisms by which PP mediates its actions on energy balance through various areas in the brain.

Pancreatic polypeptide response to a mixed meal is blunted in pancreatic head cancer associated with diabetes mellitus

INTRODUCTION

Pancreatic polypeptide (PP) is a hormone secreted by islet cells of the ventral pancreas. It has been proposed that a blunted PP response to a mixed meal can distinguish diabetes mellitus (DM) secondary to pancreatic disease from other types of DM. We performed a proof of concept study to determine if PP response to a mixed meal discriminates DM secondary to pancreatic cancer (PaCDM) from type 2 DM (T2DM).

METHODS

We studied 18 subjects with new onset DM (PaCDM (n = 9) and T2DM (n = 9); matched for age and gender). Serum PP levels were measured at 0, 30, and 60 min following a mixed meal. Increases in PP levels from baseline were compared using the Wilcoxon test.

RESULTS

In PaCDM the PP increase following a mixed meal was less than T2DM at 30 min (median 60.0%, IQR, 33.0-119.8 vs. 134.5%, IQR, 117.5-265.9; p = 0.03), but statistically similar at 60 min (median 55.8%, interquartile range (IQR) 23.7-121.5 vs. 100.0%, IQR, 47.7-202.5; p = 0.17). In PaCDM subjects, the PP increase over baseline was smaller in those with a tumor located in the pancreatic head (n = 6) compared to the body/tail (n = 3) at 30 min (41.3% vs. 158.7%, p = 0.02) and at 60 min (37.4% vs. 167.4%,p = 0.04).

CONCLUSIONS

Subjects with PaCDM have a blunted PP response to a mixed meal compared to T2DM. However, the blunted PP response is only observed in those PaC subjects with a tumor located in the head of the pancreas. Confirmation in larger studies may suggest this could be used to aid screening for sporadic PaC.

Structural similarities and differences between the human and the mouse pancreas

Mice remain the most studied animal model in pancreas research. Since the findings of this research are typically extrapolated to humans, it is important to understand both similarities and differences between the 2 species. Beside the apparent difference in size and macroscopic organization of the organ in the 2 species, there are a number of less evident and only recently described differences in organization of the acinar and ductal exocrine tissue, as well as in the distribution, composition, and architecture of the endocrine islets of Langerhans. Furthermore, the differences in arterial, venous, and lymphatic vessels, as well as innervation are potentially important. In this article, the structure of the human and the mouse pancreas, together with the similarities and differences between them are reviewed in detail in the light of conceivable repercussions for basic research and clinical application.

Computer-assisted three-dimensional reconstruction of the fetal pancreas including the supplying arteries according to immunohistochemistry of pancreatic polypeptide

Purpose

Computer-assisted three-dimensional reconstruction of the fetal human pancreas was prepared to reconsider topographical relation between the dorsal/ventral anlagen and the vascular supply.

Methods

Tissue sections from the upper abdominal viscera of three fetuses were examined. Sections were immunohistochemically stained to determine pancreatic polypeptide expression, a marker of the ventral pancreas.

Results

The immunohistochemical findings were used to create three-dimensional computer-assisted reconstructions to identify pancreatic arteries. The narrowest part of the pancreas, or the neck, corresponding to a part of the dorsal pancreas, was located on the left side of the common bile duct, portal vein and gastroduodenal artery (GDA). The posterior arterial arcade accompanied the ventral pancreas, whereas the anterior arcade did not. In contrast to the GDA, the splenic artery was clearly separated from the neck in fetuses. The GDA appears to be the primary and stable arterial supply for the neck of the pancreas.

Conclusions

This observation may have implications for the preservation of the neck with the GDA during pancreaticoduodenectomy for benign and low-grade malignant diseases.

Fetal topographical anatomy of the pancreatic head and duodenum with special reference to courses of the pancreaticoduodenal arteries

PURPOSE

The purpose of this study is to provide better understanding as to how the "double" vascular arcades, in contrast to other intestinal marginal vessels, develop along the right margin of the pancreatic head.

MATERIALS AND METHODS

In human fetuses between 8-30 weeks, we described the topographical anatomy of the vessels, bile duct, duodenum as well as the ventral and dorsal primordia of the pancreatic head with an aid of pancreatic polypeptide immunohisto-chemistry.

RESULTS

The contents of the hepatoduodenal ligament crossed the superior side of the pylorus. Moreover, the right hepatic artery originating from the superior mesenteric artery ran along the superior aspect of the pancreatic head. An arterial arcade, corresponding to the posterior pancreaticoduodenal arteries, encircled the superior part of the pancreatic head, whereas another arcade, corresponding to the anterior pancreaticoduodenal arteries, surrounded the inferior part. The dorsal promordium of the pancreas surrounded and/or mixed the ventral primordium at 13-16 weeks. Thus, both arterial arcades were likely to attach to the dorsal primordium.

CONCLUSION

The fetal anatomy of the pancreaticoduodenal vascular arcades as well as that of the hepatoduodenal ligament were quite different from adults in topographical relations. Thus, in the stage later than 30 weeks, further rotation of the duodenum along a horizontal axis seemed to be required to move the pylorus posterosuperiorly and to reflect the superior surface of the pancreatic head posteriorly. However, to change the topographical anatomy of the superior and inferior arterial arcades into the final position, re-arrangement of the pancreatic parenchyma might be necessary in the head.

Unusual fusion between ventral and dorsal primordia causes anomalous pancreaticobiliary junction

Anomalous pancreaticobiliary junction (APBJ) is a congenital anomaly in which the pancreatic duct joins the common bile duct proximal to the sphincter of Oddi. Anatomical and immunohistochemical examination of the pancreas with APBJ has rarely been performed. A 72-year-old woman with gallbladder cancer and APBJ died of respiratory failure. Macroscopic features of the pancreas were examined in detail. Immunohistochemistry using anti-pancreatic polypeptide (anti-PP) antibody was done to discriminate ventral and dorsal pancreas. Macroscopically the inferior part of the head of the pancreas was smaller than normal. The posterior surface of the head was obliquely grooved. Part of the pancreatic head protruded into the posterior side of the pancreatic head. A PP-rich region was located in the superioposterior position of the pancreas head. Considering the relationship between the ventral and dorsal pancreas, it was inferred that the ventral primordium could obliquely fuse with the dorsal primordium during embryological development. As a result, APBJ occurs through an abnormal fusion between ventral and dorsal primordia.

Persistence of the left part of the ventral pancreas may cause congenital biliary dilatation

INTRODUCTION

Congenital biliary dilatation (CBD) is a congenital anomaly by which pancreaticobiliary maljunction (PBMJ) is accompanied in most patients. The etiology of these conditions is unknown. AIMS To clarify the pattern of fusion between the ventral and dorsal parts of the pancreas.

METHODOLOGY

We examined the pancreases from five patients who had PBMJ with or without CBD and five control subjects, and we detected pancreatic polypeptide (PP) immunohistochemically.

RESULTS

In cases of CBD, the pancreatic head was huge, while the uncinate process was undetectable. The dorsal portion of the head was formed by the ventral pancreas macroscopically. It was divided into PP-rich and PP-poor portions immunohistochemically. In cases of PBMJ without CBD, the uncinate process was relatively small. The PP-rich portion (ventral pancreas) was situated obliquely dorsal to the PP-poor portion (dorsal pancreas).

CONCLUSIONS

In case of CBD, the PP-rich and PP-poor portions of the ventral pancreas may be derived from the right and left parts of the ventral primordia, respectively. CBD may occur when the remnant of the left part of the ventral primordium prevents normal recanalization of the common bile duct, resulting in dilatation of the duct. In cases of PBMJ without CBD, PBMJ without CBD may be caused by abnormal fusion between the ventral and dorsal primordia.

Development of the pancreas in Xenopus laevis

Xenopus embryos have several experimental advantages for studying development. Although these advantages have traditionally been used to elucidate mechanisms of early development, they can also be exploited to investigate issues later in development such as organogenesis. We have begun to study pancreatic organogenesis in Xenopus. Using histological and molecular marker analysis, we characterized the anatomy of the developing pancreas in Xenopus embryos from the time of initial pancreatic rudiment formation to the time when the tadpole starts to feed. We examined the expression of various endocrine hormones, exocrine gene products, and pancreatic transcription factors. Interestingly, the endocrine hormone insulin has restricted expression in the dorsal pancreas. Investigation of pancreatic specification during gastrulation demonstrates that insulin expression is regionalized along the dorsoventral axis early in development.

An investigation of the relationship between duct system and A cell-rich and PP cell-rich pancreatic islets in the canine pancreas

The pancreata of four six-month-old dogs of the same mother, two with both the pancreatic and accessory pancreatic ducts (X-type) and two with only the accessory pancreatic duct (Y-type), were examined in this study. To clarify the relationships between the type of pancreatic duct system and the composition of pancreatic endocrine cells, the pancreata were examined immunohistochemically using antiserum against four types of pancreatic hormones (glucagon, insulin, somatostatin and pancreatic polypeptide). In all areas of the X- and Y-type duct system pancreata, B cells accounted for 52-82% of the total number of islet cells, and D cells accounted for 4-15%. In the X-type ducts system, the percentages of A and PP cells in the right and left lobes of the pancreas differed greatly. It was found that A and PP cells appear in inverse proportion to each other and that there exist A cell-rich and PP cell-rich pancreatic islets. The A cell-rich pancreatic islets appeared in the left lobes along the accessory pancreatic duct, while the PP cell-rich pancreatic islets were observed in the right lobes along the pancreatic duct. The body of the pancreas contained both A cell-rich and PP cell-rich pancreatic islets. In the Y-type duct systems, A cell-rich pancreatic islets appeared in the right lobes. These findings indicate that the composition of A and PP cells in pancreatic islets is closely related to the type of duct system.

An immunohistochemical and morphometric analysis of insulin, insulin-like growth factor I, glucagon, somatostatin, and PP in the development of the gastro-entero-pancreatic system of Xenopus laevis

The ontogeny of the classical islet hormones insulin (INS), glucagon (GLUC), somatostatin (SOM), and pancreatic polypeptide (PP) as well as insulin-like growth factor I (IGF-I) in the gastro-entero-pancreatic (GEP) system of Xenopus laevis (stages 41-66) was studied using double immunofluorescence and morphometric analysis. As early as stage 41, clustered INS-immunoreactive (-IR) and isolated GLUC-IR cells occurred in the pancreas. The first SOM-IR cells appeared at stage 43, followed by PP-IR cells at stage 46. About 79% of the PP immunoreactivity was confined to a subpopulation of the GLUC-IR cells. Both the GLUC/PP-IR cells and the PP-IR cells were located in a distinct area of the pancreas. The first islets occurred in premetamorphosis (around stage 50) and comprised mainly INS-IR and GLUC-IR cells. The majority of SOM-IR, PP-IR, and GLUC/PP-IR cells was dispersed. The numbers of hormone cells remained quite constant until the end of prometamorphosis (stage 58). Around stages 60-62, the islets were partly disintegrated and the numbers of islet cells slightly decreased. At stage 63, the cell number began to increase and reached the levels typical for the adult around stage 66. After metamorphic climax, the islets were reformed. In the gastrointestinal tract, transient INS-IR cells occurred prior to the adaptation of the gastrointestinal tract to feeding (stages 41-44) and during metamorphosis when there is remodeling of the gastrointestinal tract (stages 60-63). Therefore, INS released from the transient mucosal INS-IR cells may be involved in the temporary proliferation of mucosal epithelial cells. The first GLUC-IR and SOM-IR cells were seen at stage 41. PP-IR cells followed at stage 46. In contrast to the islets, GLUC-IR and PP-IR cells constituted different cell populations. Around stage 46, the first IGF-I immunoreactions appeared in the GEP-system. In pancreas, IGF-I immunoreactivity was found in the GLUC/PP-IR, cells (85-99%) but was absent from INS-IR, GLUC-IR, and SOM-IR cells. The IGF-I-IR gastro-entero-endocrine cells, however, seemed to contain none of the classical islet hormones.

Ontogeny, postnatal development and ageing of endocrine pancreas in Bubalus bubalis

The ontogenesis, postnatal development and ageing of the endocrine pancreas in mammals have not been extensively studied. In order to improve understanding of this organ, we studied the buffalo pancreas during fetal and postnatal development. Glucagon, insulin and somatostatin immunoreactive cells (i.c.) were first seen in 2-mo-old embryos. Pancreatic polypeptide (PP) i.c. were observed during the 3rd month of gestation. The early embryo pancreas was almost totally composed of endocrine tissue. The endocrine portion only slightly increased in mass with animal growth, whereas the exocrine portion noticeably increased in mass during the late fetal and postnatal periods. In adults, therefore, the exocrine portion was more evident than the endocrine portion. Three types of islet were observed in fetal and young buffalos: small, large and PP-islets. The small islets were composed of insulin, glucagon, somatostatin and PP i.c. The large islets were primarily composed of insulin i.c. and a few glucagon, somatostatin and PP i.c. The PP islets were mostly composed of PP i.c. with a few somatostatin, insulin and glucagon i.c. The number of large islets greatly diminished by adulthood. Glucagon, insulin, somatostatin and PP i.c. were also seen scattered in the exocrine parenchyma and along the duct epithelium. In the duct epithelium, these cells were either single or grouped, and they sometimes formed a protrusion projecting towards the connective tissue. These morphological features were primarily observed in fetuses and young buffalos.

Distribution of endocrine cells displaying immunoreactivity for one or more peptides in the pancreas of the adult vervet monkey (Cercopithecus aethiops)

BACKGROUND

Our previous studies on the Chacma baboon revealed that the most striking difference between islets of the ventral and dorsal regions of the pancreas was their content of A and pancreatic polypeptide (PP) cells with A cells predominating in the tail and PP cells in the uncinate and head. Cells displaying dual immunoreactivity for both glucagon and PP were also observed. The objective of this study was to establish baseline parameters of the adult Vervet monkey (Cercopithecus aethiops) pancreas so that it could be used as a primate model to investigate possible therapies for diabetes.

METHODS

Vervet-monkey pancreas was divided into uncinate, head, and tail regions, and the tissue processed for immunolabelling for pancreatic peptides using avidin-biotin-peroxidase as marker. Dot-blotting and absorption controls for antibody specificity were included because of the shared amino acid sequences in pancreatic polypeptide (PP), neuropeptide Y (NPY), and peptide YY (PYY). Endocrine cell distributions and the percentages of each cell type per region were calculated for each monkey.

RESULTS

A significant difference in the percentages of PP cells (P = 0.02) was observed between uncinate and tail regions, the distribution of NPY cells was similar to that of the PP cells, and all other distributions were similar to those reported in the literature for most animals studied. Cells displaying dual immunoreactivity for glucagon and PP or NPY, PYY and NPY, or PP, PP and somatostatin and glucagon and insulin were identified and mapped throughout the pancreas. Most co-localizations occurred in the uncinate region. Co-localization of glucagon and insulin has not, to our knowledge, been reported previously in the adult pancreas.

CONCLUSIONS

Pancreatic endocrine cell distribution in the adult Vervet monkey was found to be very similar to most other animals studied. The occurrence of cells displaying dual immunoreactivity for a number of different combinations of pancreatic peptides suggests an interesting plasticity of endocrine cells even in the adult animal.

Pancreatic polypeptide and splanchnic blood flow in anesthetized rats

The aim of the study was to evaluate the effects of pancreatic polypeptide (PP) on splanchnic blood flow in anesthetized rats. For this purpose, either PP dissolved in saline (225, 450, or 900 pmol/kg body weight/h) or saline alone was infused at a rate of 2 ml/h for 30 min. Immediately after the infusion the blood flow to the whole pancreas, islets, duodenum, and colon was measured with a microsphere technique. The highest dose of PP caused a small decrease in mean arterial blood pressure. The two lowest doses decreased duodenal blood flow, but did not affect the blood perfusion to the other investigated organs. The highest dose of PP decreased the blood flow to the pancreas, islets, and duodenum, did not affect colonic blood flow. No change in the fraction of whole pancreatic blood flow diverted through the islets could be seen after PP administration. It is concluded that administration of high doses of PP induces a general splanchnic vasoconstriction.

Peptide YY in the mammalian pancreas: immunocytochemical localization and immunochemical characterization

Peptide YY (PYY) was demonstrated by immunochemical and/or immunocytochemical methods in endocrine cells in the pancreas of adult mice, rats, guinea-pigs, cats, dogs, pigs and cows. In the pancreas of mouse and rat, immunoreactive PYY was observed in a major subpopulation of the glucagon cells (splenic lobe of the pancreas); immunoreactive PYY also occurred in a subpopulation of the pancreatic polypeptide (PP) cells (duodenal lobe), and in a few extra-insular endocrine cells dispersed throughout the pancreatic parenchyma. In the pancreas of cat, dog and pig immunoreactive PYY was found to coexist with PP, but not with glucagon. Radioimmunoassay (RIA) revealed PYY-like material in extracts of pancreas (and colon) of all the species examined. The highest concentrations were found in the pancreas of cat and mouse; moderate amounts were found in the rat and only small amounts were detected in guinea-pig and pig. The concentrations in the pancreas were uniformly much lower than those in the colon. Analysis by high performance liquid chromatography (HPLC) showed that the PYY-immunoreactive material from pancreas (and rat colon) had an elution profile very similar to that of synthetic PYY, and distinct from that of PP and neuropeptide Y.

Coexistence of glucagon and pancreatic polypeptide in human and rat pancreatic endocrine cells

Pancreatic islet cells containing both glucagon and pancreatic polypeptide simultaneously (glucagon/PP cells) were identified in the rat and human normal pancreas using immunocy-tochemical staining on consecutive serial sections and double-immunolabeling techniques on the same sections. Numerous glucagon/PP cells were found at the periphery of the islets in all regions of the pancreas, particularly in the rat. As a whole, these bipeptide-containing cells appeared in higher proportions than the cells secreting glucagon or PP separately. Double immunogold labeling performed on both surfaces of the thin tissue sections allowed differentiation between the glucagon/PP cells and the single-labeled glucagon or PP cells at the ultra-structural level. The pancreatic glucagon/PP cells displayed the morphological characteristics of either A cells or PP cells. Both peptides were found in the same secretory granules of the glucagon/PP cells and, in the human pancreas, the glucagon/PP cells displayed secretory granules with a dense core in which both peptides were rather concentrated. The coexistence of glucagon and PP is assumed to originate from the simultaneous expression of the two different genes in the same cell and suggests that the cellular processing through the rough en-doplasmic reticulum-Golgi apparatusgranule secretory pathway for both peptides takes place in parallel.

Use of polymeric reversed-phase columns for the characterization of polypeptides extracted from human pancreata. I. Effect of the mobile phase

The high-performance liquid chromatographic (HPLC) behaviour of two different styrene-divinyl-benzene-based reversed-phase (RP) columns was evaluated using crude acetic acid extracts from normal and diabetic human pancreata as samples. Acetic acid gradients in water and acetonitrile gradients in triethylammonium phosphate (TEAP) and trifluoroacetic acid (TFA) were used as mobile phases, and comparisons were made with a silica-based C4 column. When two different polymeric RP columns were eluted with acetic acid gradients in water, surprisingly similar HPLC profiles of the pancreatic extracts were obtained. Elution of the polymer-based columns with acetonitrile gradients in TFA or TEAP resulted in changes in the polypeptide selectivity of these columns, in parallel with that of a silica-based C4 column eluted under similar conditions, indicating the general usability of polymeric columns for RP-HPLC of peptides and proteins. The pronounced difference in composition between normal and diabetic samples, which also was demonstrated after size-exclusion chromatography (SEC) on a silica-based and an agarose-based high-performance SEC column, was found to be related to the different ischaemia times for the two types of pancreata.

Anatomic distribution of pancreatic endocrine tumors

Pancreatic endocrine tumors are grouped together by their common histologic, cytochemical, and ultrastructural features. Although useful conceptually, this paradigm has been unable to predict the anatomic location of different tumor types. Successful surgical excision of these tumors would be facilitated by an improved understanding of their anatomic distribution. Based on the available data, a bimodal distribution of pancreatic endocrine tumors was identified. Cluster 1 (gastrinomas, pancreatic polypeptide (PP)-secreting tumors, somatostatinomas) had 75% of tumors to the right of the superior mesenteric artery, whereas cluster 2 (insulinoma, glucagonoma) had 75% of tumors to the left of the superior mesenteric artery (p less than 0.05). This distribution is similar to that distribution predicted based on the volume density of the corresponding islet cells for insulinoma, glucagonoma, and PP-secreting tumors, but not for somatostatinoma. These findings suggest that pancreatic endocrine tumors are derived from similar cytologic precursors as pancreatic islet cells, and their distribution may be a consequence of embryologic development from either the ventral (cluster 1) or dorsal (cluster 2) pancreatic buds.

Immunohistochemical investigations of the endocrine pancreas in normoglycemic sand rats (Psammomys obesus)

A morphological analysis of the endocrine pancreas in the normoglycemic sand rat (Psammomys obesus) has been carried out and the immunoreactivity for insulin, glucagon, somatostatin and pancreatic polypeptide (PP) studied. The islets of both parts of the pancreas (pancreatic head and tail) investigated were of the 'mantle' type: centrally located B-cells and A-, D- and PP-cells at the periphery. In the 'glucagon islets' (tail of pancreas) predominated the A-cells, while the PP-cells were more abundant in the "PP-islets' (head of the pancreas).

Heterogeneities of the islets in the rabbit pancreas and the problem of "paracrine" regulation of islet cells

In addition to "external" signals conveyed by the circulation or the nervous system, the pancreatic islets obviously are regulated also by "internal" (intra-islet) signals, e.g. by the islet hormones: insulin (B-), glucagon (A-), and somatostatin (D-) cells are able to affect the secretion of the heterologous cell types. It is, however, unclear whether this functional cooperation between islet cells occurs by an intercellular route (paracrinia sensu strictore), by intra-islet "portal" vessels, or by the systemic circulation. These likely interactions are limited by islet anatomy. To identify the anatomical basis for the mutual functional relationships between the islet cells, islets of Langerhans in the rabbit pancreas were completely analyzed in immunostained serial semithin (0.5 micron) sections. The islets were found to be largely heterogenous. They were classified in three basic types: a) polycellular islets, composed of all established endocrine cells, and including two subtypes of islets, b) bicellular islets, containing only B- and A-cells or B- and D-cells, and c) monocellular islets, exclusively made up of B-cells. Concerning the modes of paracrine regulation of islet cells, the findings suggest primarily an endocrinous route of transport of the islet peptides to heterologous endocrine cells. The corresponding functional cooperation between islet cells probably is mediated rather by the systemic circulation than by intra-islet portal vessels.

Diurnal profile of pancreatic exocrine secretion and plasma levels of gut hormones (cholecystokinin and pancreatic polypeptide)

We examined diurnal changes of pancreatic exocrine secretion and plasma levels of cholecystokinin (CCK) and human pancreatic polypeptide (hPP) in men with postoperative transient external pancreatic drainage (3 with pancreatico-jejunostomy: PJ, and 5 with pancreato-duodenectomy:PD). Plasma CCK levels increased and the pancreatic exocrine secretion showed a corresponding increase after meals in both groups. In the PJ group hPP levels increased after meals and there was a significant correlation between the plasma levels of CCK and hPP. In the PD group the plasma hPP levels were not detectable throughout the study and there was a better correlation between the exocrine secretion and the plasma CCK levels than in the PJ group. Plasma CCK levels showed rhythmic changes associated with pancreatic exocrine secretion, with no significant changes in plasma glucose and insulin in the night (24:00-07:00). These results suggested that (1) the resection of the pancreatic head which is rich in hPP contents led to a complete loss of anti-CCK effects on CCK, and that (2) fluctuation in plasma CCK levels, in the fasting state, might initiate pancreatic exocrine secretion.

Differentiation of prospective mouse pancreatic islet cells during development in vitro and during regeneration

The pancreatic islets of mouse embryos are comprised of four different endocrine cell types and of cells containing a hormone (i.e., glucagon) and a catecholamine enzyme (tyrosine hydroxylase, TH) which appear sequentially during development in vivo. The presence of TH in glucagon cells, however, is transient, since adult pancreatic A cells do not express the enzyme. In this study we sought to determine whether the endocrine precursor cells are primed to differentiate and express catecholamine enzymes during their maturation following a predetermined sequence or whether these processes are regulated by environmental cues. To answer this question, we used immunocytochemical procedures to examine the differentiation of pancreatic rudiments removed from E11 mouse embryos and maintained in culture and of pancreases that regenerated in vitro from E11 pancreatic ducts. We found that although all the endocrine cell types differentiate in the gland in culture, the sequence of their appearance is different from that in vivo, suggesting that the timing of differentiation may be regulated by environmental factors. We also found that, in vitro, the pancreas contains TH-glucagon cells, indicating that the expression of the enzyme by pancreatic A cells is independent of factors present in vivo. Moreover, the fact that the TH-glucagon cells also differentiate during pancreatic regeneration suggests that the expression of the enzyme may be a characteristic stage of endocrine cell precursors during maturation.

The haemochromatotic human pancreas: a quantitative immunohistochemical and ultrastructural study

Insulin, glucagon, somatostatin and pancreatic polypeptide cells were quantified after immunoperoxidase staining in sections of pancreases obtained from nine control subjects and seven diabetic patients with primary or secondary iron overload. One was normoglycaemic, two had glucose intolerance and four presented insulin-requiring diabetes. The whole pancreas was studied, taking into account the heterogeneous distribution of the endocrine cells. In the diabetic patients, the weight of the pancreas tended to be lower. Iron overload predominated in the exocrine tissue, whereas in islets iron concentration was quite variable from case to case. At the Haemalun-Eosine staining the histological appearance of the islets was normal, their shape and size being unchanged; amyloid deposits were absent, as were atrophic islets. Immunoperoxidase staining revealed a severe reduction in the number of immunoreactive B cells in the four diabetic patients. The mass of immunoreactive B cells was calculated from their volume density and from the weight of each lobe of the pancreas. It averaged 950 mg in control subjects, 1580 mg in the normoglycaemic patient, 1010 mg in patients with glucose intolerance and 180 mg in insulin-requiring diabetic patients. The electron microscopic examination, performed in four cases, revealed that the iron deposits were restricted to B cells and associated with progressive loss of their endocrine granules. The study shows that the pancreatic islet abnormalities in iron overloaded diabetic patients are completely different from those of Type 1 (insulin-dependent) and Type 2 (non-insulin-dependent) diabetic patients. This constitutes a further argument for a specific role of iron in the pathogeny of diabetes in haemochromatotic patients.

Beckwith-Wiedemann syndrome: a quantitative, immunohistochemical study of pancreatic islet cell populations

The endocrine cell content of the pancreas of two cases of Beckwith-Wiedemann syndrome with islet cell adenomatosis were studied. Insulin, glucagon, somatostatin and pancreatic polypeptide cells were evaluated qualitatively and quantitatively with the indirect immunofluorescence method and morphometry was used to establish the volume density of the four endocrine cell populations. This evaluation showed a marked increase of insulin and glucagon cells and a lesser augmentation of pancreatic polypeptide cells and somatostatin cells. However, the percent of somatostatin cells was decreased in comparison with controls. Qualitatively, the two pancreas were characterized by the lack of segregation of glucagon and pancreatic polypeptide cells to distinct parts of the gland, with each cell type being abundant in the pancreatic region in which they are normally very sparse. The marked increase of endocrine cells often took the form of giant islet-like structures formed by smaller subunits; however, despite this increase, the distribution of insulin cells respected the normal pattern, i.e. clusters of B cells surrounded by non-B cells. These findings indicate that besides the proliferation of pancreatic endocrine cells maintaining a normal topographical distribution of B versus non-B cells, the pancreas of patients with the Beckwith-Wiedemann syndrome may have undergone abnormal development with a consequent lack of segregation of glucagon and pancreatic polypeptide cells to different parts of the gland.

Distribution and localization of regulatory peptides

A new group of modulatory substances present in both endocrine cells and central and peripheral nerves has been described in the past few years. These substances are biochemically recognized as peptides and their actions affect many bodily functions. They are now widely known as regulatory peptides. The development of new immunocytochemical techniques, closely allied to radioimmunoassay, has disclosed that the regulatory peptides are present either in cells or in nerves, in almost every tissue of the body. The presence of peptides (the classical hormones) in endocrine cells was already known at the beginning of the century, but the presence of similar substances in nerve fibers, where they probably act as neurotransmitters, is a recent and revolutionary discovery. More than 30 peptides (neuropeptides) have been found to be present in nerves, to which the term "peptidergic" has been applied, although it is now known that in certain cases a neuropeptide can be present in the same nerves as a classical neurotransmitter, for example acetylcholine with VIP, or noradrenaline with NPY. Little is known about the physiological role of these neuropeptides. It is not yet fully accepted that they act as neurotransmitters although there is strong evidence for this, particularly in the case of substance P and VIP. The investigation of the regulatory peptides is now in an initial phase. The involvement of new disciplines, such as molecular biology, in this field is producing new and very exciting discoveries, including the isolation of novel peptides and precursors, the study of which will further contribute to the understanding of the basic control mechanisms.

Development of the human pancreas: variations and pathology. A tentative classification

The pathology of the pancreas is sometimes related to the embryological development of the organ. The first part of this paper is a presentation of the embryology, morphogenesis and cytogenesis of the pancreas. A tentative classification is then proposed to group together the lesions directly related to anomalies of the position and differentiation of the pancreatic buds. Pathological processes affecting the pancreas can be divided into those related to the ducts and those related to the parenchyma of the gland. In each case anomalies arising at a given stage of development lead to different diseases of the pancreas.

Cellular composition of the human diabetic pancreas

Insulin, glucagon, somatostatin and pancreatic polypeptide cells were stained by immunoperoxidase techniques and quantitated morphometrically in sections of pancreases obtained from eight control subjects, four Type 1 (insulin-dependent) and eight Type 2 (non-insulin-dependent) diabetic patients. The whole pancreas was studied to take into consideration the heterogeneous distribution of the different cell types. From the volume density of each cell type, and the weight of each lobe of the pancreas, the total mass of endocrine tissue was calculated. It averaged 1395 mg in control subjects, 413 mg in Type 1 and 1449 mg in Type 2 diabetic patients. The loss of endocrine tissue observed in the Type 1 patients was almost restricted to the lobe poor in pancreatic polypeptide cells. In these patients, B cells were practically absent (at the most seven per section), but the 'atrophic islets' still contained numerous A, D, or pancreatic polypeptide cells. The mass of A, D and pancreatic polypeptide cells and the ratio of D to A cells were not different from those measured in the control subjects. This shows that the disappearance of B cells in Type 1 diabetes has no preferential effect on any other endocrine cell of the pancreas. In Type 2 diabetes, the mass of A cells was increased, whereas that of B, D and pancreatic polypeptide cells was not changed. This hyperplasia of A cells leads to a decrease in the ratio of B to A and of D to A cells. These alterations may enlighten certain aspects of the physiopathology of Type 2 diabetes.

Pancreatic polypeptide (PP) cells in the PP-rich lobe of the human pancreas are identified ultrastructurally and immunocytochemically as F cells

The ultrastructure of immunohistochemically identified PP cells has been investigated by applying the serial semithin/thin section technique to the human pancreas, with special reference to the posterior part of the head, reputed to originate from the ventral primordium. PP cells of this area differ from those already identified in the rest of the pancreas and correspond to a cell, not yet described in the human pancreas, characterized by larger granules of very variable shape and structure. Such granules resemble those of so-called "F cells", i.e. the PP cells of dog uncinate process and cat duodenal lobe, also coming from the ventral primordium. Thus, human "ventral lobe" PP cells have peculiar potentialities which are expressed in distinctive structural patterns of presently unknown functional meaning.

Gastro-intestinal and neurohormonal peptides in the alimentary tract and cerebral complex of Ciona intestinalis (Ascidiaceae)

Polypeptide-hormone producing cells were localized in the alimentary tract and cerebral ganglion of Ciona intestinalis using cytochemical, immunocytochemical and electron-microscopical methods. Antisera to the following peptides of vertebrate type were employed: bombesin, human prolactin (hPRL), bovine pancreatic polypeptide (PP), porcine secretin, motilin, vasoactive intestinal polypeptide (VIP), beta-endorphin, leu-enkephalin, met-enkephalin, neurotensin, 5-hydroxytryptamin (5-HT), cholecystokinin (CCK), human growth (GH), ACTH, corticotropin-like intermediate lobe peptide (CLIP) and gastric inhibitory peptide (GIP). Immunoreactive cells were found both in the alimentary tract epithelium and in the cerebral ganglion for bombesin, PP, substance P, somatostatin, secretin and neurotensin. Additionally, in the cerebral ganglion only, there were cells immunoreactive for beta-endorphin, VIP, motilin and human prolactin. 5-HT positive cells, however, were restricted to the alimentary tract. No immunoreactivity was obtained either in the cerebral ganglion or in the alimentary tract with antibodies to leu-enkephalin, met-enkephalin, CCK, growth hormone, ACTH, CLIP and GIP. Prolactin-immunoreactive and pancreatic polypeptide-immunoreactive cells were argyrophilic with the Grimelius' stain and were found in neighbouring positions in the cerebral ganglion. At the ultrastructural level five differently granulated cell types were distinguished in the cerebral ganglion. Granules were present in the perikarya as well as in axons. The possible functions of the peptides as neurohormones, neuroregulators and neuromodulators are discussed.

Quantitation of the B and A cell fractions in human pancreas from early fetal life to puberty

The morphological development of B and A cells in human pancreas was studied with immunoperoxidase strains in 172 cases ranging in age from 12 weeks of fetal life to puberty. Tissue was defined as polypeptide rich or poor to take account of the known islet heterogeneity in the gland. Pancreatic cell density was measured and B and A cell development was calculated in terms of (a) volume fraction and (b) density (micron2/100 nuclei). B cell density increased throughout fetal life to reach a peak at the postnatal age of 2 months, whereas A cell density was greatest in the 6 month fetus. The ratio of B to A cell volume fractions is approximately 1.5 throughout most of fetal life and rises postnatally to a stable value of 5 by the age of 2.5 years.

Demonstration of carboxyl-terminal PP-like peptides in endocrine cells and nerves

Pancreatic polypeptide (PP) has been isolated from the pancreas of several species, and has been localized by immunohistochemistry to a distinct population of pancreatic endocrine cells. Recently, PP-like immunoreactivity has been demonstrated outside the pancreas, in gut endocrine cells and central and peripheral nerves, in studies using antisera raised to natural PPs. The antigenic determinants recognised by these antisera are not known in any detail, and, therefore, the identity of the molecules in these extrapancreatic localizations is also unknown. We have raised an antiserum to the synthetic COOH-terminus of PP (PP6), which, therefore, is directed exclusively towards the biologically active, invariant region of mammalian PPs. PP6-like immunoreactivity was localized in pancreatic cells which were revealed also by antiserum to human PP (hPP). Outside the pancreas, no localizations were obtained with anti-hPP antiserum, whereas antiserum to PP6 demonstrated immunoreactivity in a variety of tissues including gut glucagon cells, adrenal chromaffin cells, and nerve fibres in the gastrointestinal tract and adrenal gland. We would suggest that the wide distribution in nerves and endocrine cells of PP6-immunoreactive material, which may be biologically active, should be taken into account in the search for a physiological role for PP.

The pancreatic islets in diabetes

Despite the fact that heterogeneity of diabetes in man has become more and more evident in recent years, its pancreatic pathology is still represented by two distinct entities, roughly corresponding to the classic juvenile-onset and maturity-onset types of the disease. In juvenile-onset, insulin-dependent diabetes, the pancreatic islets show severe and pathognomonic changes. B cells are greatly reduced in number already at clinical onset. Contrary to classic opinion they do not always disappear in the years to follow. Insulitis, a common finding in the pancreas of recent onset juvenile diabetic subjects, is compatible with a viral infection as well as with an autoimmune reaction as the cause of B cell destruction. In the pancreas of juvenile-onset diabetic subjects the islets, which in the past have been regarded as atrophic and inactive, are actually composed of cells containing glucagon and somatostatin. There is also a profound distortion of islet organization, and many endocrine cells are scattered as single cells in the exocrine tissue. These findings may well account for the abnormal secretory behavior of the glucagon-secreting A cells in insulin-dependent juvenile-onset diabetes. In maturity-onset, noninsulin-dependent diabetes, the pancreatic pathology is extremely variable and not pathognomonic. A numeric reduction of the B cells can be demonstrated in many maturity-onset diabetic subjects, but this reduction is much more moderate than in insulin-dependent juvenile-onset diabetic subjects and does not account for the disease. The same amount of B cell reduction can be found in many elderly subjects without clinical evidence of diabetes. In many maturity-onset diabetic subjects, the cytologic characteristics of the B cells suggest a decreased responsiveness to the stimulus of hyperglycemia. Islet fibrosis and hyalinosis (amyloidosis), although common, cannot explain this secretory dysfunction. The exact site of the defect in the B cells of maturity-onset diabetic subjects remains to be defined. Further investigations are necessary to assess the role of disturbed intraislet intercellular relationships in the pathogenesis of late-onset diabetes. The dual pattern of islet pathology in diabetes in man does not preclude a more profound heterogeneity in the etiology and pathogenesis of the disease.

Long cytoplasmic processes in pancreatic polypeptide cells

Pancreatic polypeptide (PP) cells were studied in human endocrine pancreatic tumours and in normal human pancreata by immunohistochemical techniques and electron miscroscopy. The existence of long cytoplasmic processes was demonstrated both in tumours and normal tissue. These processes are in close contact with other endocrine cells or with acinar cells. This particular morphological aspect suggests that PP cells may control the function of other cells via paracrine secretion.

Abundance of somatostatin cells in the human neonatal pancreas

Pancreatic somatostatin cells have been studied in human neonates and adults using an immunoperoxidase technique. Their volume density in the head, isthmus, corpus and tail of the gland has been estimated by morphometry. Somatostatin cells were about 20 times more frequent in the neonate (5% of all pancreatic cells) than in the adult (0.23%). Their distribution between the different zones of the pancreas showed few differences except for the lobe of the head rich in PP cells, where the volume density of somatostatin cells was 40% lower.